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目的回顾性分析冠心病介入治疗术中发生的17例冠状动脉穿孔的处理,籍以提高对合并假性动脉瘤的认识。方法 6020例冠心病介入治疗术中共有17例患者(0.28%)在介入治疗时出现冠状动脉穿孔。结果 17例冠状动脉穿孔发生后,13例采用即刻球囊间歇低压(1～2atm)封堵法治疗,其中4例在球囊封堵过程中出现假性动脉瘤,4例中1例24小时后自行封闭,2例安装带膜支架治愈,1例当时未发现和处理,30分钟后发生心包填塞,呼吸心跳骤停。最终17例患者均痊愈出院。结论冠状动脉穿孔发生后立即用球囊间歇低压封堵法治疗,发现或怀疑有假性动脉瘤时应植入带膜支架,只要发现及时,处理措施得当,预后较好。
Objective To retrospectively analyze the treatment of coronary perforation in 17 cases of coronary heart disease interventional therapy to improve the understanding of the combined pseudoaneurysm. Methods A total of 17 patients (0.28%) during 6020 coronary interventions underwent percutaneous coronary intervention during interventional therapy. Results Thirteen cases were treated with intermittent low pressure (1 ~ 2 atm) balloon occlusion in 17 cases after perforation of coronary artery. Four cases had pseudoaneurysm during balloon occlusion and one case in 24 cases After self-enclosed, 2 cases with stent-graft were cured, 1 case was not found and treated at the time, 30 minutes after the occurrence of cardiac tamponade, respiratory arrest. The final 17 patients were cured and discharged. Conclusion Coronary perforation immediately after balloon occlusion with low pressure therapy, found or suspected pseudoaneurysm should be implanted with stents, as long as found in time, the appropriate treatment, the prognosis is good.