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目的 :探讨双导丝边支保护技术在冠状动脉真分叉病变介入治疗中对边支的保护作用及远期影响。方法 :按照随机数法将138例冠状动脉真分叉病变患者随机分为单导丝组(n=68)和双导丝组(n=70),比较两组患者在主支血管支架置入后边支血管即刻闭塞和狭窄加重的情况、完成导丝交换的时间及边支需要植入支架的情况;9~12个月内复查冠状动脉造影观察主支血管再狭窄和边支血管闭塞发生情况。结果:双导丝组边支血管即刻闭塞率和边支开口狭窄加重情况比例、完成交换导丝时间和边支需植入支架的患者比例显著低于单导丝组(P<0.05);9~12个月复查冠脉造影示两组间主支支架内再狭窄率无显著差异(P>0.05),但是单导丝组边支闭塞率高于双导丝组(P<0.05)。结论:双导丝边支保护技术在真分叉病变介入治疗中可以明显减少边支的即刻(及远期)丢失率,预防边支开口狭窄加重,减少边支需要植入支架的概率,提高了手术安全性。同时,双导丝技术可以减少远期边支血管丢失,更好改善分叉病变患者的预后。
OBJECTIVE: To explore the protective effect and long-term effect of bilateral guide wire branch protection on the branch of coronary artery in the treatment of true bifurcation lesions. Methods: A total of 138 patients with coronary artery bifurcation were randomly divided into single guidewire group (n = 68) and double guidewire group (n = 70) according to random number method. Immediately after the branch of the vessel occlusion and stenosis increased to complete the guide wire exchange time and side branches need to be implanted stent situation; 9 to 12 months review of coronary angiography to observe the main branch artery stenosis and occlusion . Results: The rates of immediate occlusion of branches and branches and the increase of stenosis of the branches in the double guidewire group were significantly lower than those in the single guidewire group (P <0.05). 9 Coronary angiography at 12 months showed no significant difference in the restenosis rate between the two groups (P> 0.05), but the rate of occlusion in the single guidewire group was higher than that in the double guidewire group (P <0.05). CONCLUSION: The technique of double guide wire branch support can reduce the immediate (and long-term) loss rate of the branch in the interventional treatment of true bifurcation lesions, prevent the stenosis of the branch branch from increasing, and reduce the probability of the branch to be inserted into the branch Surgical safety. At the same time, double guide wire technology can reduce the loss of long-term marginal vessel and better improve the prognosis of patients with bifurcation lesions.