血管内窥镜在冠心病患者介入治疗中的应用

Angioscopic evaluation in interventional treatments of coronary artery disease

目的 探讨冠心病介入治疗后冠状血管内腔的情况及其与介入治疗方法的关系。方法 应用冠脉血管内窥镜观察 31例冠心病 (急性心肌梗死早期和恢复期 )患者 ,经皮冠状动脉腔内再通术(PTCR)组 14例 ,经皮冠状动脉腔内成形术 (PTCA)组 10例 ,支架置入组 15例 (其中 8例行PTCA后置入支架 )治疗后即刻及 1个月后的冠状动脉内腔血栓的形态、颜色情况。结果 在支架置入组中冠状动脉内腔均为附壁内栓 ,无一例是管腔内血栓 ;而在PTCR组和PTCA组中管腔内血栓分别占 86 %和90 % ,比支架置入组管腔内血栓多 (P <0 0 0 1)。结论 通过冠脉血管内窥镜的应用得知 ,在冠心病介入治疗中 ,支架置入术在降低急性冠状动脉闭塞及再狭窄等并发症的发生率方面优于PTCA和PTCR。

Objective To approach the relationship between situation of coronary intima after intracoronary iuntervention and the method of intracoronary intervention Methods Coronary angioscopy was performed in 31 patients with coronary artery disease 14 cases were therapied by percutaneous transluminal coronary recanalization (PTCR), 10 cases by percutaneous transluminal coronary angioplasty (PTCA), and 15 cases by stents (in which 8 cases were done after PTCA) We observed coronary conditions (thrombus′s morphocology and color) immediately and one month after therapy Results Lining thrombi were observed in all the patients (15/15, 100%) in the stenting group and protruding thrombi were found in 86% (12/14) and 90% (9/10) of the patients in PTCR and PTCA group respectively The difference was statistically significant ( P <0 001) Conclusion In intracoronary intervention of coronary artery disease, stent lowers morbility of acute coronary occlusion and late restenosis