后扩张在急性血栓病变介入治疗中的疗效观察

Observation on therapeutic effect of balloon dilation in acute thrombus disease

目的观察后扩张应用于急性血栓病变介入治疗的临床疗效。方法选取2010年8月至2012年8月冠状动脉造影证实急性血栓病变患者137例为研究对象，均行急诊经皮冠状动脉介入治疗（PCI），其中53例支架植入后未行后扩张（对照组），84例支架植入后行高压球囊后扩张（观察组）。比较两组术中并发症发生率及主要心脏不良事件（MACE）发生率。结果观察组术后残余狭窄低于对照组[（6．7±113）％比（17．1±1．8）％]，而手术时间长于对照组[（57±26）min比（48±32）min]，差异有统计学意义（P〈0．05）。观察组手术即刻无复流或慢血流发生率为3．8％（2／53），对照组为3．6％（3／84），两组比较差异无统计学意义（P〉0．05）。随访（0．9±0．2）年，对照组出现2例心肌梗死，共复查冠状动脉造影7例，2例行再次血运重建；观察组无MACE事件，共复查冠状动脉造影5例，无再次血运重建病例。结论急性血栓病变患者PCI术中球囊后扩张治疗安全可行，能够降低MACE发生率且未增加无复流或慢血流发生率。

Objective To observe the therapeutic effect of balloon dilation in acute thrombus disease. Methods After coronary angiography, 137 patients with acute thrombus disease Who were performed percutaneous coronary artery interventional therapy （PC/） from August 2010 to August 2012 were enrolled. In them, 53 patients （control group） didn＇t undergo balloon dilation after PCI, and 84 patients（observation group）underwent balloon dilation after PCI. The intraoperative complications and the major adverse cardiac events （MACE） rate were observed. Results The rate of residue stenosis in observation group was lower than that in control group：（6.7 ±1.3）% vs. （17.1 ± 1.8）%, and there was significant difference （P 〈 0.05）. The operation time in observation group was higher than that in control group： （57 ±26） min vs.（48 ± 32） min, and there was significant difference （P 〈 0.05）. The no-reflow or slow flow after PCI in observation group was 3.8%（2/53）, in control group was 3.6%（3/84）, and there was no significant difference （P〉0.05）. The follow-up time was＇（0.9 ± 0.2） years. In control group, myocardial infarction occurred in 2 patients, 7 patients reviewed coronary angiography, and 2 patients underwent revascularization. In observation group, there was no MACE. Five patients reviewed coronary angiography, and no patient underwent revascularization. Conclusions The method of balloon dilation after PCI in acute thrombus disease is safe and feasible. It can reduce the incidence of MACE, and did not increase the rate of no-reflow or slow flow.