激光心肌打孔血运重建术

Transmyocardial revascularization by laser punching

激光心肌打孔血运重建术 (TML R)是继“搭桥”和血管成型手术的第三种治疗心脏病的手术方法 ,具有开胸小、创伤小、失血少、操作难度低、手术时间短和费用低等优点 ,为那些不适合前两种手术的缺血性心脏病人提供了生存的机会 ,得到了激光医学界的普遍关注。大量临床研究结果证明 TML R可有效地改善心肌血液灌注 ,消除胸闷、心绞痛等症状 ,提高病人的生活质量。针对迄今出现的 TML R手术的不同试验结果和争议的问题进行了深入的分析 ,尤其对 TML R手术的治疗机理、参数选取、术后疗效、应用前景以及存在的难题做了细致全面的论述和探讨 ,为今后 TML

Transmyocardial laser revascularization(TMLR) is a third viable alternative to bypass surgery and angioplasty. TMLR has many advantages, such as limited chest open, little blood loss, easy operation, short time, low cost and so on. It has raised hopes for the most dismal extremes of coronary disease to patients who had been ejected from either bypass or angioplasty. Many clinical studies show TMLR can increase heart′s blood reperfusion, render angina free and improve the patients′ life quality. In this paper, based on different clinical results and opinions, the TMLR procedure, parameter selection, after-operation response, future applications and some debated questions are discussed in detail. All of them can be benefit for further studies and trials.