本文選題：邊支導(dǎo)絲保護(hù)技術(shù) + 拘禁球囊技術(shù)��； 參考：《濟(jì)南大學(xué)》2017年碩士論文

【摘要】：目的:旨在研究觀察邊支導(dǎo)絲保護(hù)技術(shù)(JWT)與拘禁球囊技術(shù)(JBT),在冠狀動(dòng)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(hù)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(jì)寧市第一人民醫(yī)院心內(nèi)科接受冠狀動(dòng)脈造影(CAG)證實(shí)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(jī)分為兩組:A組:邊支導(dǎo)絲保護(hù)組(50例);B組:拘禁球囊組(50例),通過(guò)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(wú)閉塞或夾層,最終的冠狀動(dòng)脈血流TIMI分級(jí)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(shí)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(jìn)行統(tǒng)計(jì)學(xué)分析,從而對(duì)其有效性及安全性進(jìn)行評(píng)價(jià)。結(jié)果:邊支導(dǎo)絲保護(hù)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(dǎo)絲保護(hù)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(wú)統(tǒng)計(jì)學(xué)意義,但拘禁球囊組縮短了曝光時(shí)間,減少了造影劑用量(P0.05)。術(shù)后1年,兩組間邊支血管開(kāi)口狹窄程度無(wú)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(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:拘禁球囊技術(shù)(JBT)較邊支導(dǎo)絲保護(hù)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(dǎo)絲保護(hù)技術(shù),但JBT技術(shù)在縮短手術(shù)曝光時(shí)間,避免PCI術(shù)并發(fā)癥及造影劑用量上有一定優(yōu)勢(shì),在處理冠狀動(dòng)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(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4

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本文編號(hào)：2038873