生物可吸收支架在经皮冠状动脉介入治疗非左主干病变中的临床应用价值

Clinical Value of Bioresorbable Scaffold in Percutaneous Coronary Intervention for Non-left Main Artery Diseases

目的 探讨生物可吸收支架(bioresorbable scaffold,BRS)在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)非左主干病变中的应用效果。方法 选取2020年1月—2022年12月六盘水市人民医院收治的60例经冠脉造影确诊为冠脉非左主干病变需要PCI干预的患者作为研究对象,按随机数表法分为两组,每组30例。两组均行PCI治疗,对照组术中植入药物洗脱支架(drug eluting stent,DES),观察组术中植入BRS。比较两组手术操作相关指标、术中术后并发症、心功能指标、不良心血管事件、手术成功率。结果 观察组手术操作时间、X线曝光时间分别为(40.25±4.13)、(22.41±2.15)min,短于对照组的(50.89±5.24)、(26.87±2.38)min,造影剂用量为(98.74±7.25)mL,低于对照组的(114.52±10.36)mL,差异有统计学意义(P<0.05);观察组术术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后左室射血分数为(56.75±5.39)%,高于对照组的(50.63±5.17)%,左室收缩末期内径、左室舒张末期内径分别为(38.12±3.84)、(47.45±4.28)mm,低于对照组的(42.76±4.09)、(52.95±4.71)mm,不良心血管事件总发生率低于对照组,差异有统计学意义(P<0.05)。两组手术成功率相比,差异无统计学意义(P>0.05)。结论 BRS在PCI治疗非左主干病变中效果更佳,可缩短操作时间、X线曝光时间,减少术中术后并发症发生,加快心功能恢复,降低不良心血管事件风险。

Objective To investigate the effects of bioresorbable scaffold(BRS) in percutaneous coronary intervention(PCI) of non-left main coronary lesions.Methods6 0 patients diagnosed with non-left main coronary artery lesions requiring PCI intervention by coronary angiography admitted to Liupanshui People's Hospital from January 2020 to December 2022 were selected as the research object and divided into two groups according to random number table method,with 30 cases in each group.PCI was performed in both groups.Drug eluting stent(DES) was implanted in the control group and BRS was implanted in the observation group.Operation related indexes,intraoperative and postoperative complications,cardiac function indexes,adverse cardiovascular events and operation success rate were compared between the two groups.Results The operation time and X-ray exposure time of the observation group were(40.25±4.13) min and(22.41±2.15) min,respectively,which were shorter than(50.89±5.24) mL and(26.87±2.38) min of the control group.The amount of contrast agent was(98.74±7.25) mL,which was lower than(114.52±10.36) mL of the control group,and the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative left ventricular ejection fraction of the observation group was(56.75±5.39) %,which was higher than that of the control group(50.63±5.17) %.The left ventricular end systolic diameter and left ventricular end diastolic diameter were(38.12±3.84) mm and(47.45±4.28)mm,respectively,which were lower than those of the control group(42.76±4.09) mm and(52.95±4.71) mm,the total incidence of adverse cardiovascular events was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the success rate of operation between the two groups(P>0.05).Conclusion BRS is more effective in PCI treatment of non-left main diseases,which can shorten operation time and X-ray exposure time,reduce intraoperative and postoperative complications,accelerate cardiac function recovery,and reduce the risk of adverse cardiovascular events.