本文選題：邊支導絲保護技術(shù) + 拘禁球囊技術(shù)　； 參考：《濟南大學》2017年碩士論文

【摘要】：目的:旨在研究觀察邊支導絲保護技術(shù)(JWT)與拘禁球囊技術(shù)(JBT),在冠狀動脈粥樣硬化性心臟病介入治療真分叉病變(leferve分型Ⅰ型)分支保護中的臨床療效及安全性,為真分叉病變的介入治療及處理尋找一種更為有效的策略和臨床理論依據(jù)。方法:選擇濟寧市第一人民醫(yī)院心內(nèi)科接受冠狀動脈造影(CAG)證實為冠心病真分叉病變(leferve分型Ⅰ型),并接受PCI治療的100例患者,隨機分為兩組:A組:邊支導絲保護組(50例);B組:拘禁球囊組(50例),通過觀察:(1)術(shù)后兩組患者即刻效果,比較兩組手術(shù)邊支血管殘余狹窄程度、分支有無閉塞或夾層,最終的冠狀動脈血流TIMI分級及住院期間主要心臟不良事件(包括心絞痛發(fā)作、AMI、心源性死亡)發(fā)生率;(2)手術(shù)曝光時間、造影劑用量、手術(shù)耗材;(3)接受PCI術(shù)后1年內(nèi)不良心血管事件(MACE);兩組進行統(tǒng)計學分析,從而對其有效性及安全性進行評價。結(jié)果:邊支導絲保護組術(shù)中發(fā)生1例分支閉塞,拘禁球囊組發(fā)生0例分支閉塞,邊支導絲保護組出現(xiàn)分支血管閉塞現(xiàn)象1例(術(shù)后1年),拘禁球囊組0例,兩組組間比較無統(tǒng)計學意義,但拘禁球囊組縮短了曝光時間,減少了造影劑用量(P0.05)。術(shù)后1年,兩組間邊支血管開口狹窄程度無顯著性差異(P0.05),兩組間主支血管再狹窄和MACE發(fā)生率比較無統(tǒng)計學意義。結(jié)論:拘禁球囊技術(shù)(JBT)較邊支導絲保護技術(shù)(JWT)在近期隨訪療效及即刻手術(shù)效果不劣于傳統(tǒng)邊支導絲保護技術(shù),但JBT技術(shù)在縮短手術(shù)曝光時間,避免PCI術(shù)并發(fā)癥及造影劑用量上有一定優(yōu)勢,在處理冠狀動脈分叉病變中安全有效。
[Abstract]:Objective: to study the clinical efficacy and safety of JWT-JWT-JBT and JBT in the treatment of true branching diseases of coronary atherosclerotic heart disease by interventional therapy. To find a more effective strategy and clinical theoretical basis for interventional treatment and management of true bifurcation lesions. Methods: 100 patients who received coronary angiography (CAG) and confirmed by coronary angiography (CAG) as true bifurcation lesions of coronary heart disease were selected and treated by PCI. Two groups were randomly divided into two groups: group B (50 cases) and group B (50 cases): the control group (50 cases). The immediate effect of the two groups was observed after operation. The degree of residual stenosis of the collateral vessels, whether the branches were occluded or dissected, were compared between the two groups. The final coronary blood flow TIMI grading and the incidence of major adverse cardiac events (including angina pectoris, AMI, cardiogenic death) during hospitalization were as follows: operative exposure time, dosage of contrast media, The adverse cardiovascular events within 1 year after PCI were analyzed statistically in the two groups to evaluate their efficacy and safety. Results: one case of branch occlusion occurred during operation in the side branch guide wire protection group, 0 cases in the detention balloon group, 1 case in the side branch guide wire protection group (1 year after operation, 0 cases in the detention balloon group), 1 case in the side branch guide wire protection group, 1 case in the detaining balloon group, 1 case in the side branch guide wire protection group. There was no significant difference between the two groups, but the exposure time was shortened and the dosage of contrast agent was decreased in the detention balloon group. 1 year after operation, there was no significant difference in the degree of stenosis between the two groups. There was no significant difference in the incidence of restenosis and Mace between the two groups. Conclusion: JBT is no worse than JBT in recent follow-up and immediate operation, but JBT can shorten the exposure time. It is safe and effective in the treatment of coronary artery bifurcation disease to avoid complications of PCI and dosage of contrast agent.
【學位授予單位】：濟南大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.4

【參考文獻】

相關期刊論文 前5條

1 張雨虹;賀鏗;袁國軍;;拘禁球囊技術(shù)在冠心病介入治療分叉病變分支保護中的即刻及近期臨床療效觀察[J];江西醫(yī)藥;2014年12期

2 王滿慶;馬振晶;吉巧蓮;劉勝全;黎輝;;21例真性分叉病變患者邊支球囊保護技術(shù)的療效和安全性[J];臨床薈萃;2014年07期

3 谷慶波;;藥物洗脫支架植入術(shù)聯(lián)合氯吡格雷治療冠心病療效觀察[J];中國藥物經(jīng)濟學;2013年S3期

4 羅建平;楊勇;;冠狀動脈分叉病變介入治療策略[J];中華老年心腦血管病雜志;2013年07期

5 蔣芳勇;;冠狀動脈分叉病變不同介入治療策略的效果評價[J];山東醫(yī)藥;2013年22期

，

本文編號：2038873