摘要
为探讨采用新一代钬：ＹＡＧ 激光发生器及其导管系统对我国冠心病患者进行经皮激光心肌血运重建术（ＰＭＲ）的可行性、安全性和有效性，对４ 例Ⅲ～Ⅳ级心绞痛的病人进行了ＰＭＲ 治疗。４ 例病人均为男性，年龄６２±７ 岁，心绞痛２１±９ 年，加拿大分级Ⅳ级３ 例，Ⅲ级１ 例，术后第３ 天心绞痛级别降为Ⅱ级１ 例，降为Ⅲ级２ 例，变化不大１ 例；术后１ 周降为Ⅱ级３ 例，维持Ⅲ级１ 例。结果表明：①对国人采用上述激光发生器和光纤导管系统进行ＰＭＲ 治疗是可行的和安全的；②本文所采用的操作方法简单实用、效率高、定位准确；③ＰＭＲ 对Ⅲ～Ⅳ级心绞痛者能在较短时间内控制症状。
BACKGROUND In order to explore the feasibility,safety and effect of percutaneous laser revascularization (PMR) with Holmium:YAG generator and its fibric catheter system in the treatment of Chinses patient(pt) with ischemic heart disease,four such patients with angina class of Ⅲ or Ⅳ were selected to receive PMR therapy. MATERIAL AND METHODS Pts were selected by the criteria of:① Ⅲ to Ⅳ class of refractory angina,②coronary lesions not suitable for CABG,③LVEF greater than 50%,④without myocardial infarction within 6 months,⑤myocardial ischemia confirmed by ECG,treadmill test or ECT,⑥maximum diastolic wall thickness of left ventriculum(LV) greater than 8 mm measured by echocardiograph(ECHO). MLA1 Holmium:YAG generator and PMRL 1 catheter system (CardioGenesis Corp.)were used.Before and after PMR procedure,angina class,ECG,ECHO,ECT and cardiac enzyme test were compared. RESULTS Four pts are all male,62±7 years old,with history of angina 21±9 years,refractory to 4±2 antiangina agents.Three are Canadian Ⅳ class and one is Ⅲ class.ECG shows chronic myocardial ischemia. Mean myocardial channels of 14±3 were made and 27±13 laser pulses were fired.There were no major or minor complications.In 24 hours after PMR procedure,ECG myocardiol ischemia is improved significantly.Angina class is two grade decreased in 3 pts and one grade decreased in 1 pt within 1 week after the procedure. CONCLUSIONS Our priliminary work suggests that:①It is feasible and safe to conduct PMR in countrymen by the use of Holmium:YAG laser generator and special fibric catheter.②The PMR procedure we used is effective、simple and easy to learn.③Refractory Ⅲ to Ⅳclass of angina could be controlled in relatively short time by effective PMR treatment.
出处
《空军总医院学报》
1998年第3期125-129,共5页
Journal of General Hospital of Air Force,PLA
