论文部分内容阅读
本文报道17例经皮冠状动脉腔内成形术(PTCA),其中A型病变7例,B型10例,病变形态:向心性8例,偏心性3例,完全闭塞6例。术后14例残存狭窄<20％,临床症状减轻,心电图明显改善,成功率82.3％,失败3例,均为导丝、球囊未能通过狭窄区。完全闭塞6例中5例经溶栓+PTCA术获得成功,其中2例再通后出现再灌注心律失常,1例出现夹层。1例双支病变者采用双球囊技术后出现边支闭塞。认为在PTCA成功后不要立即撤出导丝,严密观察心电图及患者变化,一旦出现急性闭塞或内膜严重撕裂一夹层时,可重复进行球囊扩张或植入支架,确保患者安全。
This article reports 17 cases of percutaneous transluminal coronary angioplasty (PTCA), including 7 cases of type A lesions, 10 cases of type B, pathological changes: 8 cases of centripetal, 3 eccentric, complete occlusion in 6 cases. In 14 cases, the remaining stenosis was less than 20%. The clinical symptoms were relieved. The electrocardiogram was significantly improved with a success rate of 82.3% and failed in 3 cases. All of them were guide wires, and the balloon failed to pass the stenosis. Of the 6 cases completely occluded, 5 cases were successfully treated by thrombolytic therapy and PTCA. Two cases had reperfusion arrhythmia and one case had dissection. A case of double-vessel disease with double balloon occlusion after occlusion. Do not immediately pull out the guide wire after successful PTCA, closely observe the ECG and patient changes, in the event of acute occlusion or severe intima tear a dissection, the balloon can be repeated or stent implantation, to ensure patient safety.