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冠状动脉急性或慢性阻塞引起的心肌严重缺血或不可逆性坏死,在临床上常表现为不稳定型心绞痛或急性心肌梗塞。为挽救缺血心肌,缓解心绞痛和缩小心肌梗塞面积,人们不断探索新的治疗措施。近几年来,对心肌缺血提出了几种新的治疗方法,本文复习近年有关文献,作一综述。经皮冠状动脉扩张术(percutaneous trans-luminal coronary angioplasty,PTCA)这是用非手术方法扩张狭窄的冠状动脉而改善心肌供血的新措施。1964年 Dotter 及Judkins 最早提出经皮插入导管以扩张因动脉硬化而致管腔阻塞的外周动脉,使血管再通,故称血管扩张术(transluminal angioplasty)。后因出血及血栓形成等并发症,临床应用受限。1976年 Gruntzig 对上述技术加以改进,制成双腔微型气囊导管,1977年首次为1例严重冠状动脉狭窄伴顽固性心绞痛的病人作了 PTCA,
Coronary acute or chronic obstruction caused by severe myocardial ischemia or irreversible necrosis, often in clinical manifestations of unstable angina or acute myocardial infarction. To save the ischemic myocardium, relieve angina and reduce the area of myocardial infarction, people continue to explore new therapeutic measures. In recent years, several new treatments for myocardial ischemia have been proposed. This article reviews the literature in recent years for a review. Percutaneous trans-luminal coronary angioplasty (PTCA) This is a new measure to improve myocardial blood supply by non-surgical methods of dilating the narrow coronary arteries. In 1964, Dotter and Judkins first proposed percutaneous insertion of catheters to dilate the peripheral arteries obstructed by atherosclerosis and recanalized blood vessels, so called transluminal angioplasty. After due to complications such as bleeding and thrombosis, clinical application is limited. 1976 Gruntzig to improve the above technology, made of dual-chamber miniature balloon catheter, 1977 for the first time in a case of severe coronary artery stenosis with refractory angina in patients with PTCA,