冠脉支架总长度与患者生活质量的关系

摘要

Objective To analyze the relationship of the total length of coronary stent and patients’postoperative quality of life. Methods A number of 280 patients who were diagnosed as coronary artery by coronary angiography and successfully completed PCI surgery in our hospital from April 2012 to March 2013 were retrospectively collected.And they were divided into 3 groups according to the total length of the coronary stent,namely:group Ⅰ (68 cases,length of the coronary stent were less than 36 mm),group Ⅱ (156 cases,length of the coronary stent were 36 ~72 mm),and group Ⅲ (56 cases,length of the coronary stent were more than 72 mm).The prognosis and quality of life of patients of the 3 groups were compared.Results There was no significant difference in terms of in-stent restenosis,angina recurrence and target vessel revascularization rates among the 3 groups within 6 months after PCI surgery (P >0.05).But the incidence rate of adverse cardiac events of the 3 groups were significant different,and group Ⅲ were significantly higher than group Ⅱ,group Ⅱwas significantly high-er than in group Ⅰ (P <0.05).It was significant different in terms of the total length of coronary stent aomng the 3 groups (P <0.01).But there was no statistically significant difference in patients’quality of life among the 3 groups (P >0.05).Conclusion Although the total length of coronary stent and patients’postoperative quality of life were of no correlation,it is still recommend to make assessment of vascular lesions carefully before surgery.For patients with stable disease,it is recommend to take conservative medication treatment.Make stent implan-tation only when it’s necessary and the length of coronary stent should be strictly controlled so as to reduce the incidence of adverse cardiac events.%目的：分析多支冠状动脉病变行经皮冠状动脉介入（PCI）术中支架总长度与患者生活质量及预后的相关性。方法收集我院2013年3月至2015年8月间经冠状动脉造影确诊为冠心病且成功完成 PCI 手术病例280例，根据支架总长度分组：小于36 mm 为Ⅰ组（68例），36～72 mm 为Ⅱ组（156例），大于等于72 mm 为Ⅲ组（56例）；比较3组患者预后及生活质量。结果3组患者经 PCI 术后6个月支架内再狭窄、心绞痛复发和靶血管再次血运重建发生率比较无统计学差异（P ＞0．05）；但不良心脏事件的发生率存在显著差异，且Ⅲ组显著高于Ⅱ组，Ⅱ组显著高于Ⅰ组（P ＜0．05）。3组患者 PCI 术支架总长度比较具有统计学差异（P ＜0．01）；但3组间患者术后生活质量比较无统计学差异（P ＞0．05）。结论尽管支架总长度与患者 PCI 术后生活质量无明确相关性，但多支冠状动脉病变植入支架前仍应仔细做好病变血管情况的评估，对稳定病变最好采用药物保守治疗，仅对必要病变实施支架置入，且支架长度应严格根据病变段长度把握，以降低不良心脏事件的发生率。