摘要
目的血管内超声在急性心肌梗支架植入治疗中的临床指导作用。方法回顾性分析2013年12月—2016年12月该院收治的急性心肌梗需要进行支架植入患者共100例,所有患者在进行急性心肌梗支架植入后进行血管内超声检查。观察支架是否充分扩张及粥样斑块负荷的变化,未达到理想扩张者再次高压扩张。结果第一次进行扩张后,血管内超声结果与理想中的植入标准相符合的仅有66处病变,剩余82处病变未达到植入标准。未达标准患者进行高压球囊再次扩张,有72处达到了理想中的支架标准,并且再次扩张后支架面积[(5.38±0.88)mm^2vs(9.08±1.03)mm^2,P<0.05]和血管面积[(14.37±1.46)mm^2对(17.25±1.22)mm^2,P<0.05]明显增加,支架的伸展性明显改善;扩张术后最小管腔直径由原先的(0.94±0.54)mm增加为(3.23±0.31)mm、面积狭窄率由原先的(82.25±9.49)%降为(7.51±2.15)%,上述指标差异有统计学意义。结论血管内超声能对支架的植入起到指导作用,并对手术效果做出实时评价;对于第一次扩张后造影结果良好,但血管内超声结果较差的患者,在血管内超声指导下进行再一次扩张可以改善支架植入的临床效果。
Objective To analyze the clinical guidance effect of intravascular ultrasound in treatment of acute myocardial infarction stent implantation.Methods 100 cases of patients needing the acute myocardial infarction stent implantation admitted and treated in our hospital from December 2013 to December 2016 were reviewed,and all patients were examined by the intravascular ultrasound after the stent implantation,and whether the stent was fully expanding or not and changes of atheromatous plaque loads were observed,and the patients without the ideal effect was for second high-pressure expansion.Results After the first expansion,the intravascular ultrasound results of 66 cases were met with the ideal implantation standards,and the other 82 lesions failed to reach the implantation standards,and the patients failing to reach the standards were for high-pressure saccule second expansion,and 72 reached the ideal stent standards,after second expansion,the stent area and vascular area obviously increased[(5.38±0.88)mm2 vs(9.08±1.03)mm2,P<0.05],[(14.37±1.46)mm2 vs(17.25±1.22)mm2,P<0.05],and the extensibility of the stent was obviously improved,and the minimum lumen diameter after the dilatation increased from(0.94±0.54)mm to(3.23±0.31)mm,and the area stenosis rate decreased from(82.25±9.49)%to(7.51±2.15)%,and the differences were statistically significant.Conclusion The intravascular ultrasound can play a guidance role in the implantation of stents,and it can conduct the real-time evaluation of operation effect,for patients with good radiography effect after first dilatation,but bad intravascular ultrasound effect,the second dilatation under the intravascular ultrasound can improve the clinical effect of stent implantation.
作者
赵宇新
陈国秀
ZHAO Yuxin;CHEN Guoxiu(Department of Cardiology,Seventh Division Hospital of Xinjiang Production and Construction Corps,Uygur,Xinjiang,833220 China;Department of Ultrasound,Seventh Division Hospital of Xinjiang Production and Construction Corps,Uygur,Xinjiang,833220 China)
出处
《系统医学》
2017年第23期52-54,共3页
Systems Medicine
关键词
血管内超声
急性心肌梗支架植入
临床指导
Intravascular ultrasound
Acute myocardial infarction stent implantation
Clinical guidance
作者简介
通讯作者:赵宇新(1975-),男,河南兰考人,本科,副主任医师,研究方向:心血管介入,E-mail:zyxzyh@126.com。
