论文部分内容阅读
目的：探讨冠状动脉夹层的造影表现、分型与临床预后的关系。材料和方法：１４例中男１３例、女１例。临床诊断冠心病，其中９例有心肌梗塞史。冠状动脉造影均显示内膜撕裂瓣片形成的线样透亮线；其中１２例为ＰＴＣＡ术后。结果：轻度内膜撕裂３例、平行夹层分离４例、局限型夹层分离５例、螺旋型分离２例。１４例中９例假腔内造影剂排空正常或轻度排空延迟，真腔无明显受压，病人无重要临床并发症。５例假腔造影剂排空延迟，真腔中－重度受压，其中３人出现急性心肌缺血和心肌梗塞体征。结论：结合临床预后冠状动脉夹层可分为真腔受压和真腔无明显受压两大类，后者一般不产生严重临床症状和体征；而前者可产生严重临床并发症，需要紧急治疗。
Objective: To investigate the angiographic findings of coronary artery dissection, classification and clinical prognosis. Materials and Methods: 13 males and 14 females were included. Clinical diagnosis of coronary heart disease, of which 9 cases of history of myocardial infarction. Coronary angiography showed a line-like translucent line formed by the intima-lacerated flap, of which 12 were PTCA. Results: 3 cases of mild intimal tear, 4 cases of parallel dissection, 5 cases of localized dissection, and 2 cases of spiral separation. Of the 14 cases, 9 cases of false intracavitary contrast medium had normal or mild emptying delay, no significant compression in the true cavity and no significant clinical complications. Delayed emptying of the contrast media in 5 cases of pseudo-cavities resulted in severe intracavitary-severe compression in 3 of whom showed signs of acute myocardial ischemia and myocardial infarction. Conclusion: Combined with clinical prognosis of coronary artery dissection can be divided into true cavity compression and true lumen without significant pressure two categories, which generally do not produce serious clinical symptoms and signs; the former can have serious clinical complications, the need for emergency treatment.