血管腔内超声指导经皮冠状动脉介入治疗在老年冠心病患者中的应用效果研究

胡婧 唐昱

【摘要】 目的：探討血管腔内超声指导经皮冠状动脉介入（PCI）治疗在老年冠心病患者中的应用效果。方法：选取2018年1月-2019年10月本院收治的冠心病患者150例。按照随机数字表法将患者分为观察组（n=75）和对照组（n=75）。对照组进行常规PCI治疗，观察组实施血管腔内超声技术指导PCI治疗。比较两组患者手术持续时间、球囊支架直径、一次支架置入良好情况，并观察两组患者术中并发症以及术后主要不良心血管事件（MACE）发生情况。结果：两组患者的手术持续时间比较，差异无统计学意义（P>0.05）;观察组球囊支架直径大于对照组，一次支架置入良好率均高于对照组，差异均有统计学意义（P<0.05）。观察组术中并发症发生率为2.7%，低于对照组的13.3%，差异有统计学意义（P<0.05）。随访6个月，在随访时间内，观察组术后MACE发生率为16.0%，低于对照组的30.7%，差异有统计学意义（P<0.05）。结论：血管腔内超声技术指导PCI治疗老年冠心病患者的效果显著，有利于提高一次支架置入良好率，降低术中并发症及术后MACE的发生率，临床应用价值高。

【关键词】 血管腔内超声 经皮冠状动脉介入 老年 冠心病 主要不良心血管事件

Study on the Effect of Endovascular Ultrasound Guided Percutaneous Coronary Intervention in Elderly Patients with Coronary Heart Disease/HU Jing， TANG Yu. //Medical Innovation of China， 2021， 18（13）： -146

[Abstract] Objective： To explore the effect of percutaneous coronary intervention （PCI） guided by endovascular ultrasound in elderly patients with coronary heart disease. Method： A total of 150 patients with coronary heart disease admitted to our hospital from January 2018 to October 2019 were selected. Patients were divided into observation group （n=75） and control group （n=75） according to random number table method. The control group was treated with conventional PCI， and the observation group was treated with endovascular ultrasound to guide PCI. The duration of operation， diameter of balloon stent， one-time good stent implantation were compared between the two groups， and the incidence of intraoperative complications and major postoperative adverse cardiovascular events （MACE） in the two groups were observed. Result： There was no significant difference in the operation duration between the two groups （P>0.05）. The diameter of the balloon stent in the observation group was larger than that in the control group， one-time good rate of stent implantation were higher than those in the control group， the differences were statistically significant （P<0.05）. The incidence of intraoperative complications in the observation group was 2.7%， compared with 13.3% in the control group， the difference was statistically significant （P<0.05）. During the follow-up period of 6 months， the incidence of postoperative MACE in the observation group was 16.0%， lower than 30.7% in the control group， the difference was statistically significant （P<0.05）. Conclusion： Endovascular ultrasound has a significant effect on the treatment of elderly patients with coronary heart disease， which is beneficial to improve the one-time good rate of stent， reduce the incidence of intraoperative complications and postoperative MACE， and has high clinical application value.

[Key words] Endovascular ultrasound Percutaneous coronary intervention Elderly Coronary heart disease Major adverse cardiovascular events

First-authors address： Nanchang First Hospital， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2021.13.035

冠心病即冠状动脉粥样硬化性心脏病，是由于冠状动脉血管发生动脉粥样硬化病变而导致血管狭窄或阻塞，造成心肌缺血、缺氧而引发的心脏疾病[1]。随着我国老龄化社会的加速发展以及人们饮食结构的变化，冠心病的临床发病趋势呈现逐年攀升状态，这类患者通常表现出心绞痛、恶心呕吐、发绀、休克甚至心力衰竭等症状，给患者生活质量、生命安全、家庭负担带来了极大的影响[2-3]。经皮冠状动脉介入治疗（percutaneous coronary intervention， PCI）是目前临床治疗冠心病的常用方式，其主要是通过将特制的带气囊导管送至冠状动脉狭窄处后充盈气囊以扩张狭窄部位，并放置支架，避免后期再狭窄，维持供血[4]。但由于冠心病患者病情复杂，介入治疗前需要对冠状动脉血管管腔信息进行了解，以确保引导钢丝顺利通过靶血管部位，提高治疗成功率。有学……