血液透析患者冠心病介入治疗的临床应用--附4例临床报告

方路; 张芸; 周蓉; 张书富; 陈德

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中国血液净化 ›› 2005, Vol. 4 ›› Issue (9) : 497-499.

论著

血液透析患者冠心病介入治疗的临床应用--附4例临床报告

方路张芸周蓉张书富　陈德

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摘要

目的探讨血液透析患者冠状动脉造影、经皮冠状动脉成形术及支架置入术的近期疗效。方法　对４例血液透析冠心病患者在强化透析及水化治疗基础上应用非离子型低渗造影剂行冠状动脉造影术（PTCA）。结果　４例冠状动脉造影术患者，２例为多支病变，行PTCA置放支架4个，１例行钝缘支血管瘤栓塞。术后心绞痛症状缓解，肾功能无进一步恶化。结论　血液透析患者中行心脏介入性治疗，可提高透析患者生存质量，降低心血管病因的病死率。

Abstract

Objective To investigate the possibility of coronary revascularization in uremic patients on dialysis. Methods Four uremic patients were treated successfully with percutaneous transluminal coronary angioplasty and stenting. In order to minimize the adverse effect on kidney due to contrast, non-ionic and low-osmolar contrast medium was used and coronary angiography were performed on the bas's of frequent dialysis and fluid administration. Result Coronary angiography showed that two patients have multiple vessels lesion, four stents were placed. An arteriomyomatosis was blocked in one patient. After operation angina pectoris disappeared and no deterioration of renal function was noted. Conclusion It is possible to perform coronary angiography, PTCA and stenting successfully in uremic patients on hemodialysis successfully, provided due attention was paid to the choice of contrast medium and protective measures for renal function.