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目的 总结分析我院心内科冠状动脉介入治疗 (PCI)的并发症发生率、发生原因和防治措施。方法 应用回顾性调查的方法对在本院心内科于 1988年 10月至 2 0 0 3年 12月冠心病介入治疗的主要并发症类型、发生率及其年度分布特征进行统计分析 ,并进一步分析与严重并发症发生有关的危险因素。结果 共 15 0 1例进行PCI;总的并发症发生率 5 5 3% ;主要并发症有住院期间死亡(0 5 9% )、急诊CABG(0 13% )、非致死性Q波心肌梗死 (0 13% )、冠状动脉穿孔 (0 2 0 % )、球囊破裂(0 2 0 % )、支架脱落 (0 13% )、冠状动脉痉挛 (1 87% )、急性闭塞 (1 5 3% )、无复流 (0 73% )、心室颤动(0 33% )、左主干夹层 (0 13% )、急性左心功能不全 (0 2 6 % )等。单纯球囊扩张患者急性闭塞和冠状动脉痉挛发生率高 ,支架置入后明显降低 (分别由 4 4 1%和 2 4 8%降至 1 0 5 %和 1 2 3% ) ;冠状动脉介入治疗严重并发症的主要危险因素是急性心肌梗死时急诊介入治疗。结论 随着经验的积累 ,介入治疗并发症的发生率降低 ,但仍应引起介入医师重视。
Objective To summarize and analyze the incidence, causes and prevention and treatment of complications of coronary intervention in our department. Methods A retrospective survey was conducted to analyze the types, incidences and annual distribution characteristics of major complications in coronary intervention from October 1988 to December 2003 in our hospital. Risk factors associated with serious complications. Results A total of 151 cases were performed PCI. The overall complication rate was 53.3%. The main complications were hospital stay (0 59%), emergency CABG (0 13%), nonfatal Q wave myocardial infarction (13%), coronary artery spasm (18%), acute occlusion (15%), coronary artery perforation (0.2%), balloon rupture , No-reflow (0 73%), ventricular fibrillation (0 33%), left main dissection (0 13%), acute left ventricular dysfunction (0 26%) and so on. Patients with simple balloon dilatation had a high incidence of acute occlusion and coronary spasm, significantly reduced after stent placement (from 41.4% and 24.8% to 105% and 123%, respectively), and coronary intervention The major risk factor for serious complications is emergency intervention in acute myocardial infarction. Conclusion With the accumulation of experience, the incidence of interventional treatment complications decreased, but should still cause the interventional physician attention.