冠心病合并外周动脉硬化病变的联合介入治疗

Interventional treatment of coronary heart disease and outer periphery arteriosclerosis

目的探讨冠心病合并外周动脉硬化病变的联合介入治疗的近期效果及安全性。方法对2013-01—2015-09间收治的57例冠心病合并外周动脉硬化病变患者行常规抗血小板治疗,加强血糖控制,稳定血压,并持续性服用他汀类药物。依据患者病情状况及症状分别或同时采取冠状动脉介入治疗（PCI）与外周动脉介入治疗（PPI）。观察记录治疗期间并发症及不良心脏事件发生情况。随访3~6个月,行血管造影复查冠状动脉狭窄率。结果对124处冠状动脉靶病变采取PIC介入治疗,共计植入冠状动脉支架135枚,每例植入1~4枚;PCI介入治疗即刻成功率100%。患者术后心绞痛症状及时缓解有效率98.25%（56/57）,仅1例术后未完全血运重建,伴有轻度心绞痛,在采取抗凝治疗同时应用硝酸酯类、β受体阻断剂等药物抗心肌缺血治疗后症状消失。PPI治疗靶血管89支,共植入89枚外周动脉支架,每例植入1~2枚;其中PCI、PPI共同次治疗22例,余下35例均为单次择期治疗,PPI介入治疗即刻成功率高100%。患者治疗期间均未发生急性心肌梗死、脑梗死等不良心脏事件,仅2例术后出现一过性肾功能不全,后经对症处理后痊愈,患者均存活出院。结论对冠心病合并外周动脉硬化病变患者采取联合介入治疗,可提高治疗效果,降低术后并发症发生率,为患者后期动脉严重狭窄病变的防治提供保障。

Objective To investigate the outer peripheral atherosclerotic lesions in coronary heart disease and joint intervention treatment strategies,investigate the efficacy and safety of treatment. Methods A retrospective analysis of our hospital from January 2013 ~ September 2015 admitted coronary heart disease and outer periphery arteriosclerotic lesions in 57 patients were given antiplatelet therapy during the regular hospital treatment,strengthen diabetes control,stabilze high blood pressure,and continuing to take statin drugs; based on the patient ＇s condition or symptoms taking respectively coronary intervention（ PCI） and peripheral artery interventional therapy（ PPI）; complications and adverse cardiac events were recorded during the treatment,followed up for 3 ~ 6 months do angiography for coronary stenosis rate. Results To124 coronary target lesion take the PIC intervention,a total of 135 coronary stent implantation,every patient implant 1 to 4; PCI interventional treatment success rate up to 100% immediately,the patient ＇s condition angina symptoms significantly improved,its efficiency as high as98. 25% remission（ 56 /57）,only one patient postoperative incomplete revascularization,with mild angina,while taking anticoagulant nitrates therapy,β blocking drugs anti- ischemic therapy,symptoms disappear. PPI treatment target vessel 89,89 were implanted peripheral artery stent,implanted per patient 1 to 2; wherein PCI,PPI common treatments 22 cases,and the remaining 35 cases were single elective treatment,PPI interventional treatment immediate success rate up to 100%. during the treatment on acute myocardial infarction,cerebral infarction and other adverse cardiac events were occurred,only 2 patients had transient renal insufficiency,and healed after treatment,57 patients were discharged alive. Conclusion To coronary artery disease patients with outer periphery atherosclerotic lesions the joint intervention therapeutic effect is high safe,and reduce the incidence of complications in patients during treatment; to provide important protection late stage patients with severe stenosis of the artery.