本文選題：冠心病　切入點(diǎn)：多支血管病變　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:對(duì)比和評(píng)估冠心病多支血管病變(MVD)患者經(jīng)皮冠脈支架置入術(shù)(PCI)與冠狀動(dòng)脈旁路搭橋術(shù)(CABG)兩種血運(yùn)重建方式的臨床療效及預(yù)后,為MVD患者再血管化策略的選擇提供可行性的參考依據(jù)。方法:回顧性分析2012年1月至2015年12月在安徽醫(yī)科大學(xué)第一附屬醫(yī)院首次行血運(yùn)重建治療的MVD患者437例,其中PCI組225例,CABG組212例。比較兩組患者圍術(shù)期基線資料特征,隨訪兩組患者首要終點(diǎn)事件包括總死亡、心源性死亡、再發(fā)心肌梗死、腦血管意外事件及再次血運(yùn)重建等主要心腦血管不良意外(MACCA)的發(fā)生率,次要終點(diǎn)事件即再發(fā)心絞痛的發(fā)生率。結(jié)果:入選患者全部完成隨訪,隨訪率為100%,平均隨訪時(shí)間為24個(gè)月。兩組患者隨訪時(shí)間內(nèi)總死亡率(4.9%VS 4.2%)、心源性死亡率(3.6%VS 1.9%)以及腦血管意外事件的發(fā)生率(6.2%VS 5.2%)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。PCI組再發(fā)心肌梗死的發(fā)生率(4.0%)高于CABG組(0.9%),P0.05,且PCI組再次血運(yùn)重建的發(fā)生率(19.1%)、MACCA發(fā)生率(28.9%)及再發(fā)心絞痛的發(fā)生率(30.2%)均明顯高于CABG組(分別為1.4%、10.4%、6.1%),差異具有顯著性意義(P0.001)。結(jié)論:冠心病多支血管病變PCI組與CABG組患者術(shù)后隨訪時(shí)間內(nèi)死亡率無(wú)明顯差異,但PCI組患者術(shù)后MACCA和再次血運(yùn)重建的發(fā)生率均明顯高于CABG組。
[Abstract]:Objective: to compare and evaluate the clinical effect and prognosis of two kinds of revascularization methods: percutaneous coronary stenting (PCI) and coronary artery bypass grafting (CABG) in patients with multivessel coronary artery disease (MVD). Methods: from January 2012 to December 2015, 437 patients with MVD underwent the first revascularization therapy in the first affiliated Hospital of Anhui Medical University. The baseline data of the two groups were compared during perioperative period. The primary endpoint events of the two groups included total death, cardiac death, and recurrent myocardial infarction. The incidence of major cardiovascular and cerebrovascular malfunction accidents such as cerebrovascular accidents and revascularization, and secondary terminal events, namely, recurrent angina pectoris. Results: all the patients were followed up. The follow-up rate was 100 and the average follow-up time was 24 months. There was no significant difference in the total mortality rate of 4. 9% vs 4. 2%, cardiac death rate 3. 6 vs 1. 9% and the incidence of cerebrovascular accidents in the 2 groups during the follow-up period (P 0. 05. 5. 2 vs 5. 2) there was no significant difference in the incidence of recurrent myocardial infarction in the PCI group. The incidence of recurrent angina pectoris in the PCI group was significantly higher than that in the CABG group (1.4%, 10.4%, P 0.01), and the difference was significant (P 0.001). Conclusion: the incidence of revascularization in the PCI group is significantly higher than that in the CABG group (P < 0.01). Conclusion: the incidence of revascularization in the PCI group is significantly higher than that in the CABG group (P 0.05). Conclusion: the incidence of recurrent angina pectoris in the PCI group is significantly higher than that in the CABG group (1.4 + 10.4%, P 0.05). Conclusion: there is a significant difference between the two groups. There was no significant difference in postoperative mortality between PCI group and CABG group. But the incidence of MACCA and revascularization in PCI group was significantly higher than that in CABG group.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 ;急性ST段抬高型心肌梗死診斷和治療指南[J];中華心血管病雜志;2015年05期

，

本文編號(hào)：1671507