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目的通过观察冠心病患者行部分血运重建(即单纯处理近期引起心肌缺血的血管)冠脉介入手术后胸闷症状及心功能的改善情况,阐明此种手术的有效性及安全性。方法观察冠心病患者因反复胸闷、气紧而行冠脉造影后需介入支架治疗者40例,单纯在近期明显狭窄的血管处行支架治疗,余陈旧病变不干预,40例患者虽非在同一导管室手术,但手术原则相同,比较患者术前及术后胸闷症状及心功能的变化。结果 40例患者中原有35例反复胸闷,占87.5%,术后只有2例仍有胸闷,占5%,余症状明显缓解(P<0.05)。术前30例患者彩超提示:左心功能减低,其中5例心功能Ⅲ级占12.5%,EF值<45%,左室内径平均值:(56±12)mm,术后只有1例心功能Ⅲ级占2.5%(P<0.05),EF值<45%,余患者EF值较术前提高,左室内径平均值:(48±7)mm,有1例出现上消化道出血,4例出现皮肤出血点,1例出现脑卒中。结论部分血运重建介入手术可以改善高龄冠心病患者的症状及心功能,同时安全性较好。
Objective To observe the improvement of chest tightness and cardiac function after coronary intervention in patients with coronary heart disease undergoing partial revascularization (that is, simply treating the blood vessels that cause myocardial ischemia) to clarify the effectiveness and safety of such surgery. Methods 40 cases of patients with coronary heart disease due to repeated chest tightness and tightness after coronary angiography were involved in stenting were treated 40 cases of simple stenosis in the recent vascular stenting, more than the old disease does not interfere with the 40 patients although not in the same Catheter room surgery, but the same principles of surgery, patients with preoperative and postoperative chest tightness symptoms and changes in cardiac function. Results Among the 40 patients, 35 cases had repeated chest tightness, accounting for 87.5%. Only 2 cases still had chest tightness after operation, accounting for 5%. The remaining symptoms were relieved (P <0.05). Color Doppler echocardiography showed that left ventricular function was reduced in 30 patients before surgery. Among them, 5 had cardiac function grade III accounting for 12.5%, EF value <45%, mean left ventricular diameter (56 ± 12) mm, and only 1 cardiac function Ⅲ grade accounted for 2.5% (P <0.05), EF value <45%, more than the other EF patients increased preoperatively, the mean left ventricular diameter: (48 ± 7) mm, 1 case of upper gastrointestinal bleeding, 4 cases Bleeding point occurred, 1 case of stroke. Conclusions Partial interventional revascularization can improve the symptoms and cardiac function in elderly patients with coronary heart disease, and at the same time it is safe.