【摘要】 目的 :总结分析激光血运重建术治疗冠心病的临床经验。资料及方法 :收治 3例冠心病患者均为不稳定性心绞痛 ,有陈旧性心肌梗死 1例 ,3例均合并Ⅱ期高血压病。超声心动图左室射血分数为 0 .5 7～ 0 .6 2 ,FS 0 .2 8～0 .30。经心肌核素扫描 (99mTc-MiBi)及心电图检查均提示前壁及下壁缺血。在全麻下经左胸前外侧第 5肋间进胸 ,显露左心室壁 ,采用高功率二氧化碳激光打孔器 (梅曼公司HL - 10 0型 )在左室缺血区域打孔 8～ 14个。结果 :3例病人术后 2周全部康复出院 ,术后无心律失常 ,无心衰及心肌梗死 ,术后心绞痛症状均全部缓解 ,一般体力活动不受限制。结论 :激光血运重建术治疗冠心病是安全、有效的 ,对于国人由于冠状动脉血管纤细 ,激光血运重建术适应症可适当放宽更多还原

【Abstract】 Objective:To review the clinical experience of sole transmyocardial laser revascularization (TMLR) in treatment of coronary heart disease (CHD).Material and Methods:Three cases were all unstable angina,age was between 45～64 yearsold.Past medical history included 100% hypertension,prior AMI 33.3%.Left ventricular ejection fraction was between 0.57～0.62,FS 0.28～0.30,ECG and SPECT ( 99m Tc-MiBi) showed anterior and inferior wall ischemia.TMLR was performed on the beating heart via a left anterolaterial thoracotomy in the fifth intercoseal space.CO 2 laser mashine (Meiman HL-100) was used.Transmyocardial penetration number was between 8～14 in ischemic zone.Results:The perioperative mortality was.There was not post-operative complication,such as AMI,left ventricular failure.Angina were all not existence.Mean recovery time was two weeks.Conclusion:Sole TMLR is a safe and effective procedure for treatment of end stage CHD especially for not amenable to PTCA or CABG.The indication for TMLR should be extended in our country.更多还原