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目的 :提高对冠状动脉内支架植入术中并发症的认识及处理水平。方法 :自 1 996年 1月至1 999年 1 2月对 1 6 7例冠心病患者 2 0 2支血管行冠状动脉介入治疗 ,共植入支架 1 81个 ,支架植入成功率 99.4% (1 80 /1 81 )。结果 :术中共发生并发症 1 9例次 ,发生率为 1 0 .5% (1 9/1 81 )。 1 0例支架植入后 ,出现支架近端或远端正常血管严重痉挛 ,经反复冠脉内给硝酸甘油或舌下含服硝苯地平胶囊后改善。 6例次支架植入后造成病变近端和 /或远端正常血管撕裂 ,其中远端血管急性闭塞和夹层形成各 1例 ,需植入第 2个支架 ,1例经球囊低压粘贴 1 2 0 s,病灶明显改善。支架扩张不完全和斑块塌陷各 1例。支架定位不良 1例。结论 :冠状动脉内支架用于冠心病治疗有较高的成功率和较好的临床效果 ,但也有一些并发症发生 ,如处理不当可导致严重后果甚至死亡 ,应引起足够的重视
OBJECTIVE: To improve the understanding and management of the complications of intracoronary stent implantation. Methods: From January 1996 to January 1999, 162 patients with coronary artery disease were enrolled in the study. One hundred and seventy-six coronary stents were implanted into coronary artery disease patients, and the success rate of stent implantation was 99.4% 1 80/1 81). Results: A total of 19 complications occurred during operation, the incidence rate was 10.5% (19/1 81). Ten cases of stent implantation, the proximal or distal scaffold appears serious vascular normal spasm, after repeated intracoronary nitroglycerin or sublingual nifedipine capsules improved. 6 cases of subcutaneous stent implantation caused the proximal and / or distal normal vascular tear, including acute distal vascular occlusion and the formation of dissection in 1 case, the need for implantation of the second stent, 1 case of low pressure paste the balloon 1 2 0 s, lesions significantly improved. Incomplete stent expansion and plaque collapse in 1 case. Stent poor positioning in 1 case. Conclusion: Coronary stent for coronary heart disease treatment has a high success rate and good clinical results, but there are also some complications, such as improper handling can lead to serious consequences and even death, should cause enough attention