血管内超声在复杂高危患者冠脉介入诊疗中的临床价值研究OA
Clinical Value Study of Intravascular Ultrasound in the Diagnosis and Treatment of Coronary Intervention in Complex and High-risk Patients
目的:探讨血管内超声(IVUS)在复杂高危患者冠脉介入诊疗中的临床价值.方法:回顾性收集广州市花都区人民医院 2016 年 1 月—2022 年 1 月收治的 285 例行冠脉介入治疗的复杂高危患者的临床资料,依据患者检查方法分为冠状动脉造影(CAG)组(n=142)和IVUS组(n=143).比较两组手术相关指标(病变血管成功开通率、完全血运重建率、手术时间)、支架置入情况(支架置入数量、支架直径、支架长度、扩张球囊直径)、手术相关并发症发生率、住院期间主要不良心血管事件(MACE).并统计两组患者随访 1 年的Killip心功能分级、射血分数(EF)、再住院率、依从性、复查CAG情况、1 年内因心血管疾病死亡率.结果:两组病变血管成功开通率、完全血运重建率、手术时间、支架置入数量、围手术期并发症、住院期间MACE发生情况、随访 1 年的复查CAG情况及 1 年内因心血管疾病死亡率比较,差异均无统计学意义(P>0.05);IVUS组支架直径、支架长度均长于CAG组,扩张球囊直径、随访1 年的再住院率均低于CAG组,且IVUS组随访 1 年的Killip心功能分级、EF、依从性均高于CAG组,差异均有统计学意义(P<0.05).结论:IVUS在复杂高危患者冠脉介入诊疗中对病变血管成功开通率、完全血运重建率可获得与CAG相似的诊疗效果,且对手术时间及围手术期并发症、MACE发生情况无明显影响,同时能够优化支架置入情况,改善患者远期心功能及再住院率.
Objective:To explore the clinical value of intravascular ultrasound(IVUS)in the diagnosis and treatment of coronary intervention in complex and high-risk patients.Method:A retrospective collection of clinical data was conducted on 285 complex high-risk patients who underwent coronary intervention treatment admitted to Huadu District People's Hospital of Guangzhou from January 2016 to January 2022,they were divided into coronary angiography(CAG)group(n=142)and IVUS group(n=143)based on the patient examination method.The operation-related indicators(successful patency rate of diseased vessels,complete revascularization rate,operation time),stent implantation(number of stent implantation,stent diameter,stent length,balloon diameter),incidence of operation-related complications,and major adverse cardiovascular events(MACE)during hospitalization were compared between the two groups.And the Killip cardiac function grading,ejection fraction(EF),readmission rate,compliance,review CAG status,and mortality rate due to cardiovascular disease within one year were calculated for two groups of patients who were followed up for 1 year.Result:There were no statistical significant differences in the successful patency rate of diseased vessels,complete revascularization rate,operation time,number of stents inserted,incidence of perioperative complications,MACE during hospitalization,review CAG at 1 year,and mortality rate due to cardiovascular disease within 1 year between the two groups(P>0.05);the diameter and length of stent in the IVUS group were longer than those of the CAG group,while the diameter of the dilated balloon and the readmission rate at 1 year follow-up were lower than those of the CAG group,and the Killip cardiac function grade,EF,and compliance in the IVUS group were higher than those in the CAG group at 1 year follow-up,the differences were statistically significant(P<0.05).Conclusion:IVUS can achieve similar diagnostic and therapeutic effects as CAG in the successful patency rate of diseased vessels and complete revascularization rate in complex and high-risk patients with coronary intervention,and has no significant impact on operation time,incidence of perioperative complications and MACE.At the same time,it can optimize stent placement,improve long-term cardiac function,and readmission rate of patients.
许卫;朱洪海;刘欣
广州市花都区人民医院心血管内科 广东 广州 510800广州市花都区人民医院心电图室 广东 广州 510800
血管内超声复杂高危冠脉介入
Intravascular ultrasoundComplexHigh-riskCoronary intervention
《中国医学创新》 2024 (005)
55-59 / 5
广州市花都区科技计划项目(21-HDWS-022)
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