上海市经皮穿刺冠状动脉腔内成形术现状调查

Investigation of current status of PTCA in Shanghai

目的了解上海市经皮穿刺冠状动脉腔内成形术（ＰＴＣＡ）现状，探讨今后发展方向。方法翻阅１９９７年独立开展ＰＴＣＡ手术医院所有病人病史。访问各有关导管室主任或主要操作人员。结果医院数１４家，超过２００例／年的医院１家。总例数４４０例，资料完整的２６０例，其中５６％为心肌梗塞，４８％为多支血管病变。院内主要心脏事件发生率为２．６％。支架植入病例数占总数的５６．５％。ＰＴＣＡ或ＰＴＣＡ加支架大于２０例／年的医院比小于２０例／年的医院住院天数、总费用低。结论上海市年病例数不多。减少并发症、降低成本需提高每家医院的年例数。预测支架植入病人将会增加。

Objective To undersdand the current status of percutaneous transluminal coronary angioglasty(PTCA) in Shanghai. Methods Review of all the medical records of PTCA operation cases in 1997.Interviewed all the directors or main operators of duct department. Results There were altogether 440 PTCA cases in 14 hospitals,among whom myocardial infarction 56%,multiple coronary artery lesions 48%.One hospital had cases beyond 200 .The incidence of serious cardiovascular events was 2.6% during hospital admission. Hospitalization expenses and days differed significantly between hospitals with less than 20 cases per year and more than 20 cases per year. Conclusions The number of PTCA done was unsufficient to the need of the patients with coronary heart disease. To reduce complications and decrease costs are necessary to increase PTCA case number per year per hospital.