无预扩张直接冠状动脉内支架置入术20例临床观察

Clinical Observation of Direct Coronary Stenting without Predilation:Report of 20 Cases

目的 :探讨无预扩张直接冠状动脉内支架置入术的可行性、临床效果及其优越性。方法 :将 46例冠心病病人随机分为无预扩张直接冠状动脉内支架置入术组 (观察组 )2 0例 ,与传统的经球囊预扩张后冠状动脉内支架置入术组 (对照组 ) 2 6例进行对比分析。结果 :两组病人手术操作成功率相似 ,均能获得满意的支架置入后冠状动脉造影结果 ;缓解心绞痛的效果两组无差异 ;随访期间两组均未发生死亡、急性心肌梗死等心脏急性事件 ;但观察组可缩短手术时间 3 4.87% ,减少X线曝光时间 2 6.76% ,减少造影剂用量 3 5 .80 % ,降低治疗费用 2 7.62 %。结论 :无预扩张直接冠状动脉内支架置入术是一种安全有效的治疗方法 ,在某些方面优于传统的经球囊预扩张后冠状动脉内支架置入术。

Objective:To explore the feasibility,clinical efficacy and advantage of direct coronary stenting without predilation.Methods:46 coronary heart disease patients were divided randomly into two groups:treatment group was directly coronary stenting without predilation(20 patients);control group was traditional coronary steating with predilation(26 patients).Comparing and analyzing them.Results:The success rate of operation is similar for patients of two groups.Both of two groups could obtain satisfactory result of coronary angiography,and two groups has no difference on relieving angina pectoris.During the period of follow-up,there isn't heart urgent accident(such as death,AMI)occurred in all these patients of two groups.But the operating time of treatment group come down to 28.25%,The time of x-ray exposure come down to 26.76%,the dose of radiography come down to 35.80% and the fee of treament come down to 28.37%.Conclusion:Direct coronary stenting without predilation was safe and feasible therapy.It has some advantages comparing tradition coronary stenting with predilation.