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目的对比弥漫性病变介入治疗过程中,在应用普通球囊扩张的基础上应用切割球囊是否对分支血管增加了保护作用。方法入选2014年1月~2015年12月间于中国人民解放军总医院心血管内科200例冠状动脉粥样硬化性心脏病(冠心病)患者,通过计算机随机软件随机分为两组,一组在普通球囊基础上加用切割球囊100例,另一组单纯应用普通球囊预扩张100例,术后即刻观察手术成功率(残余狭窄小于10%)、分支受累情况、手术引起的外周血管并发症及围手术期心血管MACE事件情况(复发心绞痛、急性心肌梗死、心律失常、心力衰竭、冠心病死亡)。结果切割球囊组患者100例,普通球囊组患者100例,两组患者在性别构成,年龄,危险因素,心功能,既往病史几个方面进行比较,差异无统计学意义。切割球囊组与普通球囊组在即刻造影结果上相比对分支影响明显降低(P=0.005),围手术期并发症上也低于普通球囊组(P=0.032)。结论对于弥漫性病变治疗过程中,应用切割球囊行预扩张及血管成形术对比普通球囊减少了分支的闭塞率,并发症较少,是临床实践中治疗冠状动脉弥漫性病变安全、有效、可行的方法。
Objective To compare whether the application of cutting balloon on the basis of common balloon dilation can increase the protective effect on the branch vessels during the interventional treatment of diffuse lesions. Methods A total of 200 patients with coronary heart disease (CHD) who were admitted to Department of Cardiology, PLA General Hospital from January 2014 to December 2015 were randomly divided into two groups randomly. 100 cases of cutting balloon were added on the basis of ordinary balloon, 100 cases of simple balloon pre-expansion were applied in the other group. The success rate of operation (residual stenosis less than 10%), branch involvement, peripheral blood vessel Complications and perioperative cardiovascular MACE events (recurrent angina, acute myocardial infarction, arrhythmia, heart failure, death from coronary heart disease). Results There were 100 patients in the cutting balloon group and 100 patients in the common balloon group. There was no significant difference between the two groups in terms of sex composition, age, risk factors, cardiac function and past medical history. Compared with the conventional balloon group, the effect on the branch was significantly lower in the cutting balloon group than in the conventional balloon group (P = 0.005), and the perioperative complications were also lower than those in the common balloon group (P = 0.032). Conclusion For the treatment of diffuse lesions, the application of cutting balloon pre-expansion and balloon angioplasty compared to ordinary balloon to reduce the occlusion rate of the branch, fewer complications, is the clinical practice of treatment of diffuse coronary lesions safe, effective, Feasible method.