择期冠状动脉造影9 196例并发症分析

Complications in selective coronary angiography :analysis of 9196 cases

目的 探讨择期冠状动脉造影并发症发生率、危险因素和防治措施。方法 应用回顾性调查的方法对本院介入治疗中心 1987年 10月～ 2 0 0 0年 12月间 9196例冠状动脉造影的并发症类型、发生率及其年度分布特征进行统计分析 ,并分析与冠状动脉造影有关的危险因素和防治措施。结果 9196例冠状动脉造影患者。总的并发症发生率为 1 33%。手术相关病死率为 0 0 2 %。其中非致死性Q波心肌梗死、冠状动脉痉挛、严重心律失常、造影剂严重过敏反应、周围血管并发症和心力衰竭的发生率分别为 0 0 1%、0 13%、0 2 9%、0 0 4%、0 35 %、0 0 8%。行冠状动脉造影者无 1例需要进行急诊冠状动脉旁路移植手术。并发症发生率至 2 0世纪 90年代中期后明显降低。与冠状动脉造影并发症发生有关的独立危险因素包括 :不稳定性心绞痛、冠状动脉多支病变、左主干病变和心力衰竭。结论 随着经验积累 ,冠状动脉造影并发症发生率降低。本组并发症发生率较文献报道低 ,可能与严格掌握适应证 ,积极防治并发症有关。

Objective To study the incidence rates, risk factors ,prevention and treatments of complications of selective coronary arteriography. Methods A retrospective survey was conducted on the data of the incidence and annual distribution characteristics of complications among 9 196 cases that underwent selective coronary arteriography performed October 1987 to December 2000, and analyze the risk factors and prevention and treatment of these complications.Results The total complication rate was 1.33%. The procedure-related mortality rates were 0.02%. The incidence rate of non-fatal Q wave myocardial infarction, coronary artery spasm, severe arrhythmia, severe contrast allergic reaction, peripheral vascular complication, and heart failure in coronary arteriography was 0.01%, 0.13%, 0.29%, 0.04%, 0.35%, and 0.08%, respectively. No emergent coronary artery bypass surgery was required in patients with coronary arteriography. The independent risk factors of the complications of coronary arteriography included unstable angina, coronary multivessel disease, left main coronary artery disease and heart failure. Conclusion The complication rate of coronary arteriography decrease with the accumulation of experience. The complication rate in this group is lower than in other reports probably due to strictly selecting of indication and active prevention and treatment of complications.