摘要
目的:对比冠状动脉分叉病变患者急诊PCI采用单支架和双支架植入的临床效果。方法:回顾性收集2022年1月至2023年8月期间于本院接受急诊PCI治疗的104例冠状动脉分叉病变患者的临床资料。根据PCI中不同支架植入策略分为单支架组(n=54例)和双支架组(n=50例)。分析比较两组的手术相关指标、术后6 m主支与分支TIMI血流分级3级占比及主要不良心血管事件发生情况。结果:两组的手术成功率及住院时间均无显著差异(P>0.05)。与单支架组相比,双支架组的手术时间,术中造影剂用量显著高于对照组(P<0.05)。两组术后6 m的主支TIMI血流分级3级占比无显著差异(P>0.05)。与单支架组相比,双支架组术后6 m的分支TIMI血流分级3级占比显著高于对照组(P<0.05)。与单支架组相比,双支架组术后6 m主要不良心血管事件发生率显著降低(P<0.05)。结论:冠状动脉分叉病变急诊PCI中采用双支架植入,较单支架植入能获得更好的冠状动脉分支血流灌注改善效果,减少术后主要不良心血管事件发生,但存在手术时间延长、术中造影剂用量较多的问题。
Objective:To compare the clinical effect of single stent implantation and double stent implantation in patients with coronary artery bifurcation disease.Methods:The clinical data of 104 patients with coronary bifurcation disease who received emergency PCI in our hospital from January 2022 to August 2023 were retrospectively collected.The patients were divided into single stent group(n=54 cases)and double stent group(n=50 cases)according to different stent implantation strategies in PCI.The operation-related indexes,the proportion of TIMI grade 3 in the main branch and branch 6 months after operation and the occurrence of major adverse cardiovascular events were analyzed and compared between the two groups.Results:There were no significant differences in the success rate of operation and length of stay between the two groups(P>0.05).Compared with the single stent group,the operative time and the amount of contrast agent in the double stent group were significantly higher than those in the control group(P<0.05).There was no significant difference between the two groups in the proportion of primary branch TIMI grade 3 at 6 months after operation(P>0.05).Compared with the single stent group,the proportion of branch TIMI grade 3 in the double stent group at 6 months after operation was significantly higher than that in the control group(P<0.05).Compared with the single stent group,the incidence of major adverse cardiovascular events in the double stent group at 6 months after surgery was significantly reduced(P<0.05).Conclusion:Compared with single stent implantation,double stent implantation in emergency PCI for coronary bifurcation lesions can achieve better improvement effect of coronary branch blood perfusion and reduce the occurrence of postoperative adverse cardiovascular events.However,there are problems such as longer operation time and more intraoperative contrast agent.
作者
陈雪斌
张冠茂
Chen Xue-bin;Zhang Guan-mao(Puyang People's Hospital,Puyang 457000,Henan,China)
关键词
冠状动脉分叉病变
经皮冠脉介入术
支架
不良心血管事件
Coronary artery bifurcation disease
Percutaneous coronary intervention
Stand
Adverse cardiovascular events
