激光心肌血运重建术治疗不稳定型心绞痛的临床研究

Clinical study of transmyocardial Laser revascularization in treating unstable angina

目的 :观察激光心肌血运重建术 (TML R)治疗不稳定型心绞痛的临床疗效。方法 :5例冠心病患者均为不稳定型心绞痛者 ,其中有陈旧性心肌梗死 2例 ,曾施行经皮腔内冠状动脉成形术 (PTCA) 1例。5例心肌核素扫描 (99m Tc- Mi Bi)及心电图均提示前壁、下壁缺血 ,其中 3例有外侧壁缺血。在全麻下经左胸前外侧第 5肋间进胸、显露左室 ,应用高功率 CO2 激光器在左室缺血区域打孔 8～ 14个。结果 :5例患者术后 2周全部康复出院。术后心绞痛症状均有不同程度缓解 ,术后半年缓解明显 ( 级→ 级 ) ,体力活动较术前明显改善 ,术后 1年心绞痛均为 0级。结论 :TML R治疗不稳定型心绞痛安全、有效 ,对于不宜做 PTCA及冠状动脉旁路移植术的患者 ,TML

Objective:To observe the clinical effects of sole transmyocardial Laser revascularization(TMLR)in treatment of unstable an gina.Method:Five cases were all unstable angina and all had pas t history of hypertension, and 2 cases had MI, and 1 case had performed PTCA. EC G and SPECT showed anterior, inferior and lateral wall ischemia. TMLR was perfom ed with left anterolateral thoractomy in the fifth intercostal space. CO 2 Lase r machine was used, and transmyocardial penetrations were done 8~14 times in isc hemic zone for each patient.Result:All five patients were rehabilitated and discharge d from hospital 2 weeks after treatment. A half year later, angina was significa ntly alleviated from grade Ⅳ to grade Ⅰ and one year later angina was redued t o grade 0.Conclusion:Sole TMLR is a safe and effective procedure for treating unstable angina especially for those patients who can not receive PTCA or CABG. The indication for TMLR may be appropriately widened in our country.