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目的:评价激光心肌血运重建术(TMLR)治疗重症2型糖尿病并冠状动脉粥样硬化性心脏病(冠心病)患者的临床疗效。方法:应用TMLR治疗24例重症2型糖尿病并冠心病病人(A组),并与同期治疗的36例非糖尿病冠心病患者(B组)的疗效进行比较。结果:A组症状改善率62%(13/21),B组为68%(21/31);放射性核素心肌显像检查显示A组有10例(48%)心肌缺血明显改善,B组有14例(45%),P>0.05;心电图结果与核素心肌显像结果基本一致(P>0.05);心排血指数(EF):A组由术前平均0.48变为术后的平均0.56,B组由术前平均0.51变为术后的平均0.58(P>0.05)。总有效率A组为67%,B组为74%,两组无显著性差异(P>0.05)。术后切口感染A组4例(19%),B组5例(15%),两组相似(P>0.05)。围手术期死亡A组3例,B组5例。结论:对于重症2型糖尿病并冠心病患者,TMLR是一种安全、有效的治疗方法。。
Objective: To evaluate the clinical effect of laser revascularization (TMLR) in patients with severe type 2 diabetes and coronary atherosclerotic heart disease (CHD). METHODS: TMLR was used to treat 24 patients with severe type 2 diabetes mellitus and coronary heart disease (A group) and compared with 36 patients with non-diabetic coronary heart disease (B group) treated at the same period. Results: The symptom improvement rate was 62% (13/21) in group A and 68% (21/31) in group B. The radionuclide myocardial imaging examination showed that 10 cases (48%) had markedly improved myocardial ischemia in group A, B (P> 0.05). The cardiac output (EF) in group A was changed from 0.48 before operation to An average of 0.56, B group from an average of 0.51 before surgery to an average of 0.58 (P> 0.05). The total effective rate was 67% in group A and 74% in group B, with no significant difference between the two groups (P> 0.05). Postoperative incision infection in 4 cases (19%) in group A, 5 cases (15%) in group B, the two groups were similar (P> 0.05). Perioperative death in group A 3 cases, B group 5 cases. Conclusion: TMLR is a safe and effective treatment for patients with severe type 2 diabetes mellitus and coronary heart disease. .