摘要
目的 观察 80岁以上冠心病患者接受经皮冠状动脉 (冠脉 )腔内介入治疗术 (PCI)的安全性和有效性。 方法 对 43例≥ 80岁的冠心病患者的 48支相关血管进行PCI 45次 ,其中右主干11支 ,左前降支 2 5支 ,回旋支 11支 ,左冠状动脉 1支。与 2 37例 <80岁行PCI的冠心病患者进行比较。 结果 37例患者手术成功 ,手术成功率 86 1% ,再通 42支病变血管 (87 5 % ) ,置入冠脉内支架16枚 ,成功率 10 0 0 %。 6支血管再通失败 ,其中 5支左前降支 (LAD) ,手术相关并发症 2例 ,均为LAD近端闭塞扩张后再闭塞或引起左主干 (LM)夹层 ,其中 1例术后 1周死于室性心动过速。随访 37例 ,平均随访时间 (18 0± 8 8)个月。手术后 6～ 12个月行冠脉造影随访 2 5例 ,再狭窄率 36 0 %。 结论 对 80岁以上冠心病患者行PCI治疗是安全有效的 ,成功率较高 ,并发症少 ,但应严格掌握手术适应证。
Objective To evaluate the safety and efficiency of percutaneous coronary interventions(PCI) in octogenarian Chinese with coronary artery disease. Methods A total of 43 patients aged over 80 years old underwent 45 such procedures at Queen Mary Hospital from October 1994 to May 1998. There were 27 male and 16 female 〔 mean age (82.3±2.5), range (80 89)〕. 55.8% of these patients had multi vessel lesions. A total of 48 lesions in 43 patients was treated 〔25 LAD(52 1%), 11 LCX(22 9%) , 11 RCA(22 9%), 1 LM (2 1%)〕. Results Thirty seven (86.1%) patients were successfully performed PCI. Sixteen of them deployed stenting. Among the 6 lesions which failed to cross, 5 of lesions were LAD, 3 of them were total occlusion. The success rate and complication during the procedure were not significant difference compared with the control in 237 patients <80 years of age. At 18 months follow up, 78.5% of these patients was free or much improved of chest pain. The restenosis rate was 36.0% confirmed by coronary angiogram performed in 25 patients. Conclusions In octogenarians with coronary artery disease PCI was a safe and effective procedure with a high successful rate, low acceptable complication rate and a favorable immediate and long term outcomes.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2001年第2期108-110,共3页
Chinese Journal of Geriatrics
