摘要
目的:探究分析冠状旁路移植术(CABG)序贯经皮冠状动脉介入术(PCI)治疗65岁以上老年冠心病患者的近期临床疗效及其安全性。方法:选择在我院进行手术的冠脉多支病变患者153例,年龄均在65岁以上。按照手术方法的不同分为杂交手术组(77例,接受CABG及序贯PCI治疗)和单纯PCI组(76例,接受PCI治疗)。观察两组患者手术情况、近期临床疗效、院内及12个月内不良事件发生情况。结果:与单纯PCI组比较,杂交手术组造影剂用量[(176.2±79.8)ml比(145.7±67.6)ml]显著减少,平均住院天数[(8.9±4.1)d比(6.8±3.4)d]和使用支架总长度[(67.16±36.12)mm比(36.53±27.31)mm]显著缩短,术后12月SYNTAX评分[(23.1±7.2)分比(14.8±9.5)分]显著减少,院内发生的不良事件中急性心衰(10.5%比1.3%)、造影剂肾病(13.2%比3.9%)发生率显著降低,12个月内发生的不良事件中急性心衰(11.7%比3.8%)、复发心绞痛(14.5%比3.9%)发生率均显著降低,P<0.05或<0.01。结论:和单纯PCI术相比,冠状动脉杂交术具有更显著的近期临床疗效,较好的安全性。
Objective:To explore short-term therapeutic effect of coronary artery bypass grafting(CABG)sequential percutaneous coronary intervention(PCI)on > 65 years aged patients with coronary heart disease(CHD)and its safety.Methods:A total of 153 patients with multiple vessel coronary disease on>65 years aged were selected.According to operation method,they were divided into hybrid surgery group(n=77,received CABG and sequential PCI)and pure PCI group(n=76,received PCI).Operation condition,short-term therapeutic effect,incidence of adverse events inhospital and within 12 months were observed and compared between two groups.Results:Compared with pure PCI group,there were significant reductions in contrast agent dosage[(176.2±79.8)ml vs.(145.7±67.6)ml],mean hospitalization days[(8.9±4.1)d vs.(6.8±3.4)d],total length of used stents[(67.16±36.12)mm vs.(36.53±27.31)mm],SYNTAX score on 12 months after operation[(23.1±7.2)scores vs.(14.8±9.5)scores],incidence rates of in-hospital adverse events:acute heart failure(10.5% vs.1.3%),contrast agent nephropathy(13.2% vs.3.9%),adverse events within 12 months:acute heart failure(11.7%vs.3.8%)and recurrent angina pectoris(14.5%vs.5.7%)in hybrid surgery group,P<0.05 or<0.01.Conclusion:Compared with pure PCI,coronary hybrid operation possesses more significant short-term therapeutic effect and significant better safety.
作者
董京京
DONG Jing-jing(First Department of Cardiology,Second Central Hospital of Baoding City,Baoding,Hebei,072750,China)
出处
《心血管康复医学杂志》
CAS
2020年第1期58-62,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
