摘要
目的探讨激光心肌打孔血运重建术（ＴＭＬＲ）治疗重症冠心病的疗效。方法对冠心病患者气管内插管全身麻醉，经左侧第五肋间做前外侧切口进胸，在食管超声探头（ＴＥＥ）监测下施术，平均打孔（３１．４±４．９）个（２６～４２个），通畅率９６％。全组无心腔内腱索、瓣膜和传导组织损伤。术后死亡３例，存活２７例，平均随访（７．４±６．１）个月（１～１８个月），心绞痛缓解两级和两级以上者２６例（９６．３％），３～６个月时心脏核素检查显示打孔区域心肌灌注由（４２±１８）％升至（５３±２２）％（Ｐ＜０．０１），未打孔区域无明显变化。结论ＴＭＬＲ术能有效缓减心绞痛，改善心肌供血，为重症冠心病患者带来了希望。
Objective This paper is to report the clinical process and results of Transmyocardial Laser Revascularization (TMLR) in 30 patients with ischemic heart disease Methods All patients who underwent left anteriolateral thoracotomy through 5th intercostal space,were intubed and a transesophageal echocardiography (TEE) probe was inserted31449 holes were lased in mean,The penetrated rate was 96% by TEE confirmedAnd without any damage to chordae tendinaevalve and conductive system3 cases died of postoperative defibrillation,of 27 cases survival were followedup for 7461 months (1￣18 months) Results Postoperative angina class relief (CCS) more than 2 grades were 26 cases (963%),the myocardial perfusion increased from 4218% to 5322% (P<001) by isotope scans in the lased area,and no change in nonlased area Conclusion TMLR can get relief of angina,make better myocardial perfusion,it is effective to end stage of coronary artery disease
出处
《中国介入心脏病学杂志》
1999年第1期24-26,共3页
Chinese Journal of Interventional Cardiology
