应用小C臂X光机和经皮冠状动脉腔内成形术治疗冠心病34例(摘要)

中国循环杂志 1999年第0期第14卷 摘要　冠心病介入治疗

作者：姚立云　王乐丰　李乃达　陆文豹　张学坤　郭金成　张海滨　刘林宝

单位：北京市，通州区潞河医院　心内科(101149)

　　目的：评价应用小C臂X光机进行经皮冠状动脉腔内成形术(PTCA)的可行性和有效性。

　　方法：回顾分析34例自1998年2月至10月应用小C臂X光机进行PTCA治疗冠心病的临床资料。本组男32例、女2例，平均年龄56.29±9.9岁。临床检查示有心肌缺血，21例为急性心肌梗塞、11例为不稳定性心绞痛、2例为稳定性心绞痛。6例为多支血管病变，28例为单支病变，其中单支多发病变13例，9例为分叉部病变。前降支及其分支24支、回旋支及其分支7支、右冠状动脉9支。40处狭窄病变，10处阻塞病变、其中2处为慢性阻塞病变。A型病变1处、B型病变17处(34%)、C型病变32处(64%)。

　　结果：本组病例成功率为88.2%(31/34)、血管成功率为87.5%(35/40)、病变成功率为90%(45/50)。成功病例狭窄由术前平均(93.3±4.6)%(±s)减少到术后的(3.9±6.7)%。A型和B型病变均成功，C型病变为84.4%(27/32)。本组82.4%(28/34)因PTCA术后结果不满意或有撕裂而置入支架。本组2例术后因心源性休克和室性心动过速死亡。除2例多支血管病变有心绞痛复发，其余病例随访结果良好。分析表明病变类型与成功率、并发症、和再狭窄密切相关。

　　结论：应用小C臂X光机能够满足基层医院介入心脏病治疗的需要。

Percutaneous Transluminal Coronary Angioplasty with Small C Arm X-Ray Machine with 34 Cases (Abstract)

Department of Cardiology, Luhe Hospital, Beijing (101149)

　　Yao Liyun, Wang Lefeng, Li Naida, et al.

　　Objective: To evaluate the feasibility and efficiency with small C arm X-ray machine performing percutaneous transluminal coronary angioplasty (PTCA).

　　Methods: Clinical data of 34 cases of coronary artery diseases performing PTCA with small C arm X-ray machine between February 1998 and October 1998 were analysed retrospectively. There were 32 males 2 females with a mean age of 56.3±9.9 years old. Twenty on of them were acute myocardial infarction, 11 unstable angina, 2 stable angina with clinical evidence of myocardial ischemia. Six cases were multivessel disease, 28 cases single vessel disease with 13 tandem lesions, 9 cases bifurcation lesions. Left anterior descending artery and its branches were 24, left circumflex and its branches 7, and right coronary artery 9. Forty were stenotic lesions, 10 occlusive lesions with 2 chronic occlusive lesions. One were type A lesions, 17 (34%) type B lesions, and 32 (64%) tyep C lesions.

　　Results: Procedureal success rate was 88.2% (31/34), vessel success rate 87.5% (35/40), lesion success rate 90% (45/50). Stenosis was decreased from preprocedureal (93.3±4.6)% (±s) to postprocedural (3.9±6.7)%. Success rate was 100% (18/18) for type A and B lesions, 84.4% (27/32) for type C lesion. Stent was used in 82.4% (27/32) cases due to suboptimal balloon angioplasty and intimal dissections. Two cases died of cardiogenic shock and ventricular tachycardia after procedures. All patients were well during the follow-up except 2 with multivessel disease who had recurrent angina. Analysis showed that lesion type closely related with success rate, complication, and restenosis.

　　Conclusion: The application of small C arm X-ray machine could meet the need for interventional cardiology in county hospital.