冠状动脉造影术315例临床分析

Clinical analysis of 315 cases of coronary angiography

目的探讨冠状动脉造影术在冠心病诊断中的价值及相关并发症。方法采用seld inger法穿刺右侧股动脉或右侧桡动脉,采用Judk ins法行多角度、多方位选择性冠状动脉造影。结果315例患者冠状动脉造影阳性181例(57.5%)。该181例中受累部位前降支141例(77.9%),右冠状动脉82例(45.3%),左回旋支68例(37.6%),左主干3例(1.7%);累及单支血管病变104例(57.5%)、2支血管病变40例(22.1%)、3支血管病变37例(20.4%)。发现15例单发心肌桥,5例冠心病合并心肌桥,心肌桥发生率6.3%。1例(0.3%)冠心病合并冠状动脉瘤样扩张。出现1例(0.3%)尖端扭转型室速,1例(0.3%)腹膜后大量出血,1例(0.3%)右冠状动脉近段夹层,2例(0.6%)右侧股动脉穿刺处假性动脉瘤,11例(3.5%)血管迷走反射,皆给予相应处理后治愈,无不良后果。结论冠状动脉造影术为冠心病诊断金标准,它操作简便、创伤小、安全可靠,并指导治疗,有条件的医疗单位应积极开展。

Aim To investigate the value of coronary angiography in the diagnosis of coronary heart disease and related complications. Methods The right femoral artery or the right radial artery was punctured by Seldinger method. The selective coronary angiography of the multi-angle and multi-direction was finished by Judkins method. Results 181 positive cases （57.5%） were found in 315 cases of coronary angiography, including 141 cases （77.9%） of anterior descending artery,82 cases （45.3%） of right coronary artery disease,68 cases （37.6%） of left circumflex branch disease and 3 cases （ 1.7 % ） of left main disease. 104 cases （57.5 % ） of single-vessel disease ,40 cases （22. 1% ） of two-vessel disease,37 cases（20.4% ） of three-vessel disease were found. 15 cases of single myocardial bridge, 5 cases of myocardial bridge with coronary heart disease（ 6.3% ）, 1 case （0.3%） of coronary heart disease with coronary artery ectasia emerged. Also, 1 case（0. 1% ） of torsade de pointes, 1 case （0.3 % ） of retroperitoneal hematorrhea, 1 case （0.3 % ） of proximal right coronary artery dissection,2 cases （0.6%） of pseudoaneurysm at the right femoral artery puncture site and 11 cases （3.5 % ） of vasovagal reflex were given the appropriate treatment without adverse result. Conclusions Coronary angiography is the diagnostic gold standard of coronary heart disease. It is simple, minimally invasive, safe and reliable. Equipped medical units should be actively adopted and provide guidance for the treatment.