论文部分内容阅读
目的探讨血管内超声(IVUS)指导下介入治疗左前降支(LAD)病变的疗效。方法选取2015年11月至2016年7月收治的LAD近段或中段接受经皮冠状动脉介入(PCI)治疗的冠心病患者28例。比较冠状动脉造影指导下判定的拟置入支架的参数与IVUS指导下判定的拟置入支架的参数。以IVUS获得的参数作为最终置入支架参数。结果造影指导下预判支架长度为(30.5±11.6)mm,IVUS指导下预判支架长度为(29.2±11.4)mm,两者比较,差异无统计学意义(P>0.05)。造影指导下预判支架直径为(2.93±0.36)mm,IVUS指导下预判支架直径为(3.14±0.39)mm,两者比较,差异有统计学意义(P<0.05)。除2例造影和IVUS提示血管相对正常节段不同的患者,造影指导下预判支架长度为(29.5±11.2)mm,IVUS指导下预判支架长度为(29.3±11.5)mm,两者比较,差异无统计学意义(P>0.05);造影指导下预判支架直径为(2.91±0.35)mm,IVUS指导下预判支架直径为(3.13±0.40)mm,两者比较,差异有统计学意义(P<0.05)。结论应用IVUS指导行LAD介入治疗,获得的支架直径大于应用造影指导获得的支架直径。获得支架长度两种方法无差异。少数情况下,应用IVUS发现的血管相对正常节段与冠状动脉造影不同。
Objective To investigate the effect of interventional treatment of left anterior descending artery (LAD) under the guidance of intravascular ultrasound (IVUS). Methods Twenty-eight patients with coronary heart disease undergoing percutaneous coronary intervention (PCI) in the proximal or middle LAD from November 2015 to July 2016 were selected. The parameters to be inserted into the stent were compared with those under the guidance of coronary angiography. The parameters to be placed in the stent were determined under the guidance of IVUS. The parameters obtained with IVUS were used as the final stent parameters. Results The length of the predictive stent was (30.5 ± 11.6) mm under the guidance of angiography, and (29.2 ± 11.4) mm under the guidance of IVUS. There was no significant difference between the two groups (P> 0.05). The diameter of the predictive stent was (2.93 ± 0.36) mm under the guidance of angiography, and (3.14 ± 0.39) mm under the guidance of IVUS. The difference was statistically significant (P <0.05). In addition to the two cases of contrast-enhanced angiography and IVUS, the estimated length of the stent was (29.5 ± 11.2) mm under the guidance of angiography, and (29.3 ± 11.5) mm under the guidance of IVUS. There was no significant difference between the two groups (P> 0.05). The diameter of the predictive stent was (2.91 ± 0.35) mm under the guidance of angiography and (3.13 ± 0.40) mm under the guidance of IVUS, the difference was statistically significant (P <0.05). Conclusion IVUS guidance line LAD interventional treatment, the stent diameter obtained is greater than the diameter of the stent obtained by the guidance of angiography. There was no difference between the two methods for obtaining stent length. In a few cases, the relatively normal segments of blood vessels found by IVUS differ from coronary angiography.