高龄高危患者激光心肌血运重建术

首都医科大学学报 ›› 2000, Vol. 21 ›› Issue (3): 198-200.

高龄高危患者激光心肌血运重建术

屈正¹, 张兆光¹, 于建波¹, 叶建光¹, 孙衍庆¹, 马临安², 徐屹¹

1. 首都医科大学附属北京安贞医院心脏外科;2. 首都医科大学附属北京安贞医院CCU病房

收稿日期:2000-06-14 修回日期:1900-01-01 出版日期:2000-07-15 发布日期:2000-07-15

Transmyocardial Laser Revascularization in Senile Patients with High Risk

Qu Zheng¹, Zhang Zhaoguang¹, Yu Jianbo¹, Ye Jianguang¹, Sun Yanqing¹, Ma Lin′an², Xu Yi¹

1. Department of Cardiac Surgery, Beijing Anzhen Hospital, Affiliate of Capital University of Medical Sciences;2. Depertment of CCU, Beijing Anzhen Hospital, Affiliate of Capital University of Medical Sciences

Received:2000-06-14 Revised:1900-01-01 Online:2000-07-15 Published:2000-07-15

摘要/Abstract

摘要： 采用美国PLC产CO₂激光心脏打孔器,对33例高龄(68～78岁)冠心病心绞痛患者在食管超声心动图(TEE)监测下行心肌打孔^{[平均打孔(22±5)个]}.结果：无手术死亡,术后48h内因急性心肌梗死死亡2例,因心源性休克(原因不明)死亡1例;少数患者发生心律失常、精神症状、自发性气胸等并发症。26例患者术后随访1～36月,其中23例(88%)患者心绞痛改善或消失;16例(62%)单光子发射型计算机断层显示心肌灌注有不同程度改善。提示：应用高功率CO₂激光对高龄高危冠心病患者行激光打孔心肌血运重建术安全、有效;并应加强围术期管理.

关键词: 冠心病, 心绞痛, 激光心肌血运重建术

Abstract: To report the perioperative characteristics in transmyocardial laser revascularization (TMLR) in senile patients .TMLR was performed on the beating heart with high power CO₂ laser (the Heart Laser, ^TMPLC. Inc.)in 33 high risk cases. Transesophageal echocardiography (TEE) showed the average number of channels was 22±5. The follow up ranged from 1 to 24 months was made to assess angina class and myocardial perfusion. 2 patients died of acute myocardial infarction and one died of cardiac shock. Some people suffered related complications such as arrhythmia, pneumothorace, etal. The follow-up included 26 patients. The angina status were improved in 23(88%) patients. ²⁰¹Tl-SPECT showed a remarkable improvement in reversible ischemia in 16(62%) follow up patients. TMLR for patients with high risk is safe and effective. Monitor during operation is very important for prognosis.

Key words: coronary artery disease, angina pectoris, transmyocardial laser revascularization

中图分类号:

R654.2

屈正;张兆光;于建波;叶建光;孙衍庆;马临安;徐屹. 高龄高危患者激光心肌血运重建术[J]. 首都医科大学学报, 2000, 21(3): 198-200.

Qu Zheng;Zhang Zhaoguang;Yu Jianbo;Ye Jianguang;Sun Yanqing;Ma Lin′an;Xu Yi. Transmyocardial Laser Revascularization in Senile Patients with High Risk[J]. Journal of Capital Medical University, 2000, 21(3): 198-200.

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