320排冠状动脉CT血管造影在冠状动脉慢性完全闭塞病变介入治疗中的应用效果

Application Effect of 320-slice CT Coronary Angiography in Chronic Coronary Total Occlusion Patients Undergoing

目的分析320排冠状动脉CT血管造影在冠状动脉慢性完全闭塞病变(CTO)介入治疗中的应用效果。方法选取2013年1月—2017年2月东莞康华医院收治的CTO患者137例,根据随机数字表法将所有患者分为A组86例与B组51例。两组患者均予以介入治疗,A组患者于介入治疗前行320排冠状动脉CT血管造影检查,B组患者于介入治疗前行冠状动脉数字减影血管造影检查。比较两组患者血管再通情况、导丝未通过情况、进入假腔形成夹层情况、手术时间、耗材用量、支架长度、介入治疗成功率,并比较A组不同介入结局患者闭塞病变时间、CT值及病变长度。结果 A组患者血管再通率高于B组,导丝未通过率、进入假腔形成夹层发生率低于B组,手术时间短于B组(P<0.05)。A组患者微导管、预扩张球囊、后扩张球囊用量多于B组,支架用量少于B组,支架长度短于B组(P<0.05);两组患者导丝用量比较,差异无统计学意义(P>0.05)。A组患者介入治疗成功率高于B组(P<0.05)。A组中介入治疗成功者闭塞病变时间短于介入治疗失败者,CT值低于介入治疗失败者,病变长度短于介入治疗失败者(P<0.05)。结论 320排冠状动脉CT血管造影可提高CTO患者介入治疗时血管再通率,降低导丝未通过率及进入假腔形成夹层发生率,缩短手术时间,提高介入治疗成功率。

Objective To analyze the application effect of 320-slice CT coronary angiography in chronic coronary total occlusion(CTO)patients undergoing interventional therapy.Methods A total of 137 patients with chronic CTO patients were selected in Kanghua Hospital of Dongguan from January 2013 to February 2017,and they were divided into A group(n=86)and B group(n=51)according to random number table.Patients in the two groups received interventional therapy,thereinto patients in A group received 320-slice CT coronary angiography,while patients in B group received coronary digital subtraction angiography.Vascular recanalization rate,failed passing rate of guide wire,incidence of false lumen entry-induced dissection,duration of operation,material usage,stent length and success rate of interventional therapy were compared between the two groups,meanwhile duration of occlusive lesion,CT value and lesion length were compared in patients with different interventional outcome in A group.Results Scular recanalization rate in A group was statistically significantly higher than that in B group,while failed passing rate of guide wire and incidence of false lumen entry-induced dissection in A group were statistically significantly lower than those in B group,duration of operation in A group was statistically significantly shorter than that in B group(P<0.05).Usage of micro catheter,pre-dilation balloon and poststenotic dilation balloon in A group was statistically significantly more than that in B group,respectively,while usage of stents in A group was statistically significantly less than that in B group,stent length in A group was statistically significantly longer that in B group(P<0.05);no statistically significant differences of usage of guide wire was found between the two groups(P>0.05).Success rate of interventional therapy in A group was statistically significantly higher than that in B group(P<0.05).In A group,duration of occlusive lesion and lesion length in patients with successful interventional outcome were statistically significantly shorter than those in patients with unsuccessful interventional outcome,meanwhile CT value in patients with successful interventional outcome was statistically significantly lower than that in patients with unsuccessful interventional outcome(P<0.05).Conclusion In chronic CTO patients undergoing interventional therapy,320-slice CT coronary angiography can effectively improve the vascular recanalization rate and success rate of interventional therapy,reduce the failed passing rate of guide wire and incidence of false lumen entry-induced dissection,shorten the duration of operation.