直接支架植入术与传统支架植入术治疗冠心病的对比研究

Comparison of coronary stenting with or without predilation in patients with coronary heart disease

目的探讨直接支架植入术治疗冠心病患者的安全性、成功率和治疗效果。方法经冠状动脉造影,诊断明确,病变特征符合A型和B1型病变的冠心病患者165例,随机分为传统支架植入组(传统组)82例和直接支架植入组(直接组)83例,比较两组间手术成功率及并发症,心绞痛缓解率;支架置入时间;X线照射时间及造影剂用量。结果两组患者支架植入成功率及术后心绞痛缓解率均为100%;传统组与直接组并发症发生率均为2.4%。支架置入时间直接组(14.3±7.6)min,传统组(20.5±5.3)min,差异有统计学意义(P<0.05);X线照射时间直接组(4.9±3.5)min,传统组(7.6±2.9)min,差异有统计学意义(P<0.05);造影剂用量直接组(90±39)ml,传统组为(102±46)ml,差异有统计学意义(P<0.01)。结论直接支架植入术安全性、成功率和治疗效果与传统支架植入术一致,而且在支架植入时间、X线照射时间和造影剂用量明显低于传统支架植入术,值得临床推广应用。

Objectives To assess the clinical efficacy and security of direct stenting in patients with coronary heart disease（CHD）. Methods 165 patients with CHD approved by coronary angiography （CAG） and lesions accorded with type A and B1, were divided into 2 groups： predilation group（n=82）and nonpredilation group（n=83）. The procedural success, the incidence, angina relieving and clinical course were compared between 2 groups. Results In 2 groups, all patients were successfully treated with stenting, angina were relieved. The complication after stenting was 2.44% in the predilation group while 2.41% in the non-predilation group. There were no statistic difference between the 2 groups （P〉0.05）, but there were statistic difference in stenting period （14.3＋7.6 rain vs 20.5＋5.3 rain,P〈0.05）, X-ray radiating period （4.9＋3.5 rain vs 7.6＋2.9 rain, P〈0.05）, and iohexol dose （90＋39 ml vs 102＋46 ml, P〈0.01） in the 2 groups. Conculsions There are high security, procedural success and clinical efficacy between the 2 groups. It takes less time in stenting and X-ray radiating together with fewer iohexol dose in the non-predilation group. It is worthy to apply in the clinic.