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慢性冠状动脉闭塞置入支架术与球囊扩张术的比较 |
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董少红 丁明镐 赵廷馆 姜贞采
【摘要】 目的 为了解冠状动脉内支架及经皮冠状动脉腔内成形术(PTCA)治疗完全闭塞性冠状动脉血管的临床及冠状动脉造影效果。方法 95例完全冠状动脉闭塞的病人随机分成为：置入支架组（A组48例）；单纯PTCA组（B组47例），观察二组病人发生临床事件及6个月后的冠状动脉造影效果。结果 6个月后两组病人完成临床及冠状动脉造影随访的共85例，随访率为89％，A组42例，B组43例。A组：1例于术后10天内出现心肌梗塞，无1例死亡，其再狭窄率为28.5％，血管再闭塞率为11.9％，最终重复血管重建术为19％。B组：1例死亡，2例发生急性心肌梗塞，再狭窄率为58％，血管再闭塞率为22％，最终重复血管重建术达45％。两组之间临床疗效差异均有显著性（P<0.001）。结论 冠状动脉慢性闭塞的病人PTCA成功后选择性置入支架比单纯PTCA的近期及远期临床疗效预后要好（发生临床事件及重复血管重建术明显下降）。
【关键词】 血管闭塞 支架
Long-term clinical and angiographic outcome after stenting and angioplasty of chronic total coronary occlusion DONG Shaohong, DING Minggao, ZHAO Tingguan, et al. Division of Cardiology, Shen Zhen People′s Hospital, Shen zhen 518020
【Abstract】 Objective This study was to investigate the long-term clinical and angiographic outcome after stenting or balloon angioplasty treatment of chronic total coronary artery occlusion. Methods Ninty-five patients with successful PTCA for total occluded coronary artery were collected from 358 patients with PTCA for chronic total occlusion lesions, patients were classified into two groups, group A with selective stenting after successful PTCA (n=48), group B with PTCA (n=47) only the clinical cardiac events and angiography were evaluated after six months of the procedure.Results 85 (89%) in 95 patients were followed up, in the stent group (n=42), one patient suffered from AMI, in group B, 2 patients with AMI and one died in hospital. Restenosis rate in stent group was 28.5% compared with 58% in group B (P<0.001), the reocclusion was 11.9% in group A and 19% in group B. Recanulazation was 19% in group A and 45% in group B (P<0.01). Conclusions Selective stenting for total occluded coronary artery after successful PTCA improved the short and long-term clinical and angiographic results.
【Key words】 artery occlusion stent
经皮冠状动脉腔内成形术（PTCA）有较高的再狭窄率，冠状动脉内支架的应用可减少其术后的再狭窄率。本研究的目的在于评价成功的PTCA术后选择性置入冠状动脉内支架与单纯PTCA治疗效果的比较。
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