在患有大动脉病和并发冠状动脉心脏病的患者中采用混合方法:回顾性研究
Kostiantyn Boyko1, Borys Todurov1, Andrii Khokhlov2
1HEART INSTITUTE MINISTRY OF HEALTH OF UKRAINE, KYIV, UKRAINE; SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE.
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
|February 14, 2025
概括
混合方法将大动脉置换 (AVR) 与穿皮冠状动脉干预 (PCI) 结合起来,显示了与传统手术相似的并发症率. 患者在手术后六个月经历了更好的疼痛指数.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 心脏康复心脏康复
背景情况:
- 冠状动脉心脏病 (CHD) 和大动脉膜疾病经常同时存在,需要复杂的治疗策略.
- 传统治疗涉及单独或分阶段的干预,可能会增加患者的负担和恢复时间.
研究的目的:
- 评估一种混合方法的有效性,该方法结合了主动脉置换 (AVR) 和皮肤冠状动脉干预 (PCI).
- 为了比较混合AVR + PCI方法与AVR +冠状动脉旁路移植 (CABG) 在患有心脏病和大动脉膜疾病的患者中的结果.
主要方法:
- 在2018年至2022年期间,对130名接受心肌再血管化AVR的成年患者进行了回顾性分析.
- 第1组:51名患者 (AVR + PCI);第2组:79名患者 (AVR + CABG).
- 使用简单表格36调查 (SF-36) 评估6个月和12个月后的生活质量.
主要成果:
- 与AVR + CABG组 (p=0.0001) 相比,AVR + PCI组的心肺绕道和大动脉交叉紧时间显著缩短 (分别为1.5倍和1.4倍),而AVR + CABG组 (p=0.0001).
- 在6个月后,AVR + PCI组的患者报告了明显更好的SF-36疼痛指数 (13.5%更高,p=0.017).
- 在其他SF-36生活质量指标中,两组之间没有发现显著差异.
结论:
- 混合方法 (AVR + PCI) 的术后并发症率与传统的手术方法 (AVR + CABG) 相当.
- 接受混合干预的患者在术后六个月经历了疼痛得分的改善.
- 这种混合策略代表了一种可行且潜在的有益的治疗选择,用于选择患有结合性心血管疾病和大动脉膜疾病的患者.
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