初学者行经皮冠状动脉内支架置入术并发症(附500例临床分析)

Complications in percutaneous coronary stents implantation completed by a beginner:a clinical analysis of 500 cases

目的探讨初学者行经皮冠状动脉内支架置入术并发症的发生率和预防措施。方法应用回顾性调查的方法,分析在我院经笔者初入门时独立完成的500例经皮冠状动脉内支架置入术并发症的类型、发生率和处理方法。结果经皮冠状动脉内支架置入术并发症发生率为7.20%,手术相关病死率为0.40%。主要并发症包括非致死性Q波心肌梗死(0.60%)、冠脉夹层(0.20%)、冠脉血栓形成(0.80%)、冠脉痉挛(2.00%)、严重心律失常(0.40%)、造影剂过敏反应(0.20%)和周围血管并发症(1.40%)。结论本组以初学者为术者独立完成的病例并发症发生率较文献报道低,可能与严格掌握适应证,积极防治并发症有关。提示初学者经皮冠状动脉内支架置入术的并发症是可以控制的。

Objective To descride the complication rates,prevention and treatment of the complications in percutaneous coronary stents implantation performed by a beginner.Methods The types,the incidence and prevention and treatment of the complications in 500 cases undergone percutaneous coronary stents implantation performed mainly by authors of this article（the beginners） were reviewed and analyzed.Results During the study period,500 procedures of percutaneous coronary stents were performed.The total complication rate of was 7.20 %. The procedure-related death rates were 0.40%.The major complications included non-fatal Q-wave myocardial infarctions（0.60%）,coronary artery dissecting（0.20%）,coronary artery thrombosis（0.80%）,coronary artery spasm（2.00%）,severe arrhythmia（0.40%）,allergic reaction induced by iodine contrast medium（0.20%） and peripheral vascular complication（1.40%）. Conclusion The complication rates in this group of patients were lower than the references reported.This result was probably due to strictly evaluating the indication,actively preventing and treating the complications.It suggested that the complication can be controlled in percutaneous coronary stents implantation performed by beginners.