血管内超声在冠脉介入治疗中应用效果对比评价

Comparative Evaluation of the Effects of Intravascular Ultrasound in Coronary Interventional Therapy

目的:通过临床病例探讨并分析冠状动脉血管内超声在冠状动脉介入治疗中,冠脉支架置入术中的应用效果。方法:2018年8月~2019年6月选取辽阳辽化医院84例冠心病患者,将其分为对照组(42例)和观察组(42例),对照组行冠脉造影后,根据造影图像目测、导丝、球囊测量对比等方法行冠状动脉支架植入术,术后复查造影。观察组经冠状动脉造影后对狭窄在70%~90%的病变行血管内超声(IVUS)检查,并指导行冠状动脉支架置入术,植入支架后再次行IVUS检查,观察支架贴壁情况、及有无支架远端夹层,对支架贴壁不良的给予非顺应性球囊后扩张,对于斑块负荷重的评估斑块性质再决定是否应用切割球囊、还是直接球囊扩张。结果:观察组病变血管最狭窄部位最小血管直径(MLD)高于对照组,斑块负荷及直径狭窄率(DS)小于对照组;观察组支架置入率为92.36%、达标率90.88%,高于对照组的73.33%、66.67%,P<0.05。结论:冠状动脉血管内超声在冠状动脉介入治疗中,冠脉支架置入术中的应用效果显著,具有临床意义及应用价值。

Objective:To investigate and analyze the application effect of intravascular ultrasound in coronary intervention and coronary stent implantation through clinical cases.Methods:From August 2018 to June 2019,84 patients with coronary heart disease in Liaoyang Liaohua hospital were selected and divided into the control group(42 cases)and the observation group(42 cases).After coronary angiography,the control group underwent coronary stent implantation according to the contrast methods of angiographic images,guide wire and balloon measurement,and the angiography was reviewed after operation.In the observation group,intravascular ultrasound(IVUS)was performed on 70%-90%stenosis lesions after coronary angiography,and the coronary stent implantation was guided.IVUS was performed again after stent implantation to observe the stent adherence and whether there was stent distal dissection.Non compliant balloon dilation was given to those with poor stent adherence,and the nature of plaque was determined after evaluation of heavy plaque load whether to use cutting balloon or direct balloon dilatation.Results:The minimal vessel diameter(MLD)of the most stenotic part of the lesion in the observation group was higher than that in the control group,the plaque load and diameter stenosis rate(DS)were lower than those in the control group;the stent implantation rate of the observation group was 92.36%,the compliance rate was 90.88%,which was higher than 73.33%and 66.67%of the control group,P<0.05.Conclusion:Intravascular ultrasound in the treatment of coronary intervention,the application of coronary stent implantation effect is significant,with clinical significance and application value.