非心脏手术对已安装冠脉内药物涂层支架患者预后的影响(1)
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[摘要] 目的：观察非心脏手术对已安装冠脉内药物涂层支架患者预后的影响。方法：收集2007年1月～2009年12月安装冠脉内药物涂层支架后接受过非心脏手术的患者60例，其中27例患者在安装支架后12个月内手术(A组)，33例在安装支架后12个月后手术(B组)。另外，随机选择安装冠脉内药物涂层支架，但其后未接受过手术的患者30例作为对照(C组)。观察术后1年内(A组和B组)或安装支架后1年内(C组)主要不良心脑血管事件(MACCE)的发生情况。结果：A组的MACCE发生率显著高于C组(P<0.05)，B组与C组的MACCE发生率差异无统计学意义(P>0.05)。结论：在安装冠脉内药物涂层支架后的双抗期接受非心脏手术严重影响患者预后，非急诊手术宜在双重抗凝的12个月以后进行。
[关键词] 药物涂层支架；非心脏手术；预后
[中图分类号] R654.2[文献标识码]A [文章编号]1673-7210(2011)07(c)-031-02
The effect of noncardiac surgery on the prognosis of the patients received drug-eluting stent implantation
ZHAO Huijun1, FAN Weixing1, CHEN Changbao2, WANG Aizhong2*
1.Department of Internal Medicine, the Fourth People′s Hospital of Jiaozuo City, He'nan Province, Jiaozuo 454000, China; 2.Department of Anesthesiology, the Affiliated Sixth People′s Hospital of Shanghai Jiao Tong University, Shanghai 200233, China
[Abstract] Objective: To evaluate the effect of noncardiac surgery on the prognosis of the patients having received drug-eluting stent implantation. Methods: 60 patients who had received a noncardiac surgy after drug-eluting stent implantation were recruited between January 2007 to December 2008, 27 of them received a surgery during the dual antiplatelet treatment (12 months after stent implantation) (group A), and 33 of them received a surgery after the dual antiplatelet treatment (group B). 30 patients who did not receive any surgery after stent implantation were also recuited (group C).Main cardio-cerebral vascular events (MACCE)were recorded within one year after surgery (group A and group B) or after stenting (group C). Results: The incidence of MACCE was higher in group A than in group C (P<0.05), while there was no statistical difference between group B and group C (P>0.05). Conclusion: A noncardiac surgery during the dual antiplatelet treatment might have an adversary effect on the prognosis of the patients after drug-eluting stent implantation. An elective surgery should be carried out after 12 months of the dual antiplatelet treatment ......
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