| Purpose:Currently,interventional therapy is mainly applied for the treatment of coronary heart disease.Accordingly,in this study,patients with coronary heart disease in our hospital(Weihai municipal hospital)were selected as research objects.Two methods of conventional therapy and interventional therapy were used to evaluate the therapeutic effect of interventional therapy on elderly patients with coronary heart disease.Method:120 cases of patients who received coronary artery disease interventional therapy in our hospital from January 2017 to December 2017 were selected and divided into control group(60 cases)and study group(60 cases).Patients in the control group received conventional treatment,while those in the study group underwent endodermal coronary angioplasty and stent implantation.Patients in the study group without contraindications were required to take 300 mg of aspirin and 300 mg of clopidogrel within 24 hours before surgery.Judkin method was used to perform QCA and ACC/AHC standard classification.In other words,6F or 7F vascular sheath was placed through right femoral artery or right flexure artery.Coronary angiography was performed at first,and then suitable catheter or guide wire was selected to expand the balloon of the patient.According to patients' situation,such as the presence or absence of lesions,etc.,and then decide whether the stent implantation can be performed on patients.As a rule of thumb,the implantation should also meet the appropriate ratio.For example,for diameter > 2.5mm diseased vessels,the ratio of stent and vessel diameter was generally maintained at 1.1 or 1.2:1.In the study,the study group and the control group were divided into the interventional treatment group and the conventional treatment group.Before taking these two treatment options,patients were required to take aspirin 100mg/d and clopidogrel 75mg/d.After the operation,the patient had to aspirin 100 mg/d,and clopidogrel 75 mg/d for more than 12 months.And both groups of patients were given normal medications,nitrates,angiotensin-converting enzyme inhibitors,beta-blockers and statins.Even after the two groups of patients were discharged from the hospital,they should continue to takemedicine.The standard for successful stent placement were:(1)lumen residual stenosis<20%;(2)TIMI blood flow grade 3;(3)patients have no major clinical complications during hospitalization(eg,death,nonfatal myocardial infarction,emergency department)Coronary bypass).The standard for complete revascularization is to dilate all stenotic vessels >70.Data were collected at the post-operative 1st,3rd,6th,and12 th month for following.Three quantitative analysis applied in this thesis contains descriptive analysis,one-factor and multi-factor statistical analysis.(1)Descriptive analysis: a descriptive analysis of the basic situation of the research object.(2)One-factor analysis: chi-square test,t-test(for data in normal distribution)and Mann-Whitney test(for data in abnormal distribution)were applied to make the between-group comparison.(3)Multi-factor analysis: multiple linear regression was applied.Independent variables such as hospitalization days,number of lesion branches and ages were filtered by stepwise regression,with the entry criteria being 0.05 and the exit criteria being 0.10.The research methods adopted in this subject are as follows:(1)Qualitative analytical method:interviews were made with cardiology and management experts in our hospital to understand the detailed information about our interventional treatment.Meanwhile,data were collected for further analysis based on the record.(2)Literature analysis method:related literatures were collected through library and the internet,and then classified and analyzed,which provided adequate views and resources for this thesis.(3)Retrospective investigation: according to the cases selected by our hospital,such as age,gender,admission mode,discharge outcome,hospitalization days,related information was extracted and filled in the corresponding questionnaire,which provided retrospective sources for this study.(4)Follow-up survey: telephone or face-to-face interviews were made to obtain the related information for this study.Result:1.In our hospital,the results of a comparative study of 120 patients with coronary heart disease who received interventional therapy and routine treatment demonstrated that after interventional therapy,the patients of the study group have fewer complications,with just one in 60 cases compared with five in the control group.The improvement of all patients at the time of discharge showed that the improvement rates of the study group were significantly higher than that of the control group.All 60 cases in the study group showed improvement,while only 43 cases in the control group showed improvement.According to the above results,interventional therapy is more effective than universaltreatment for elderly patients with coronary heart disease.2.More Patients of over 75 years old have multiple coronary artery lesions.Multiple vascular lesions,complex vascular lesions(B2,C type),occlusion lesions,diffuse lesions and other cases of patients are significantly higher than the younger age group.However,the elderly group with single lesion and complete blood transport reconstruction rate was significantly lower than the younger age group(P < 0.0.5 or P < 0.001).The target lesion blood vessel distribution and immediate success rate in elder and younger groups are no difference(P > 0.005).The success rate of the aged group is 97.3%.3.The follow-up results: There were no significant differences between the elder group and younger group in the probability of cardiac death,nonfatal myocardial infarction during hospitalization regardless of complete revascularization intervention after PCI.The follow-up results of a year of cardiac death,nonfatal myocardial infarction in aged group 30 cases were no significant difference.There was no difference in coronary angiography follow-up rate(P > 0.05).Conclusion:1.Elderly patients always suffer from multiple diseases such as diabetes,hypertension,hyperuricemia,lipid disorders.Elderly patients with coronary heart disease are complex,including the more proportion of three and multivessel lesions.Hospitalized patients with myocardial infarction are higher and more serious.2.In this study,the patients were divided into different groups.There was no statistically significant difference in the success rate and the incidence of serious complications.The results show that skilled interventional therapy is safe and effective to elderly patients with coronary heart disease.3.In the study,there was no significant difference in the one-year clinical end point between elderly patients with coronary artery disease who underwent selective interventional therapy,regardless of complete revascularization.The results showed that partial revascularization interventional therapy was feasible for elderly patients with coronary heart disease. |
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