Keywords: coronary heart disease breakthrough
After the reform and opening up, we have to introduce a lot of foreign state-of-the-art medical equipment and philosophy, coronary angiography and percutaneous coronary intervention technology is one of them. However, many of the new technology, a lack of understanding or misgivings, often refused the doctor’s diagnosis and treatment recommendations, the results missed the best period of the disease treatment.
Coronary blood vessels that supply the heart. Occurrence of coronary atherosclerosis, leading to stenosis, cardiac insufficiency, occurs coronary heart disease, angina or even life-threatening myocardial infarction. In view of the increasing trend of coronary heart disease morbidity and mortality in recent years, the trend of increasingly younger age of onset of the patients was popularization of knowledge of the diagnosis and treatment of coronary heart disease, so early prevention of coronary heart disease, early diagnosis and early treatment, to become a a pressing public health mission.
How can I do early diagnosis and prompt treatment of coronary heart disease? The typical symptoms of coronary heart disease such as angina, after the onset of symptoms in a timely manner to the hospital for ECG corresponding check, may make the disease get diagnosed. However, many patients, usually without any discomfort, overwork or exercise chest pain or tightness in the chest, oppressive, rest, the symptoms will disappear naturally. These symptoms are often overlooked by patients, thus losing the opportunity of early diagnosis of coronary heart disease.
There are many ways in the diagnosis of coronary heart disease, such as ECG, exercise test, radionuclide myocardial scanning, these can provide an important basis for the diagnosis of coronary heart disease, coronary angiography is still the most reliable method for the diagnosis of coronary heart disease, called The “gold standard". This method in clinical applications have been 40 years of history, it is a small catheter is inserted through the skin puncture blood vessels in the X-ray fluoroscopic guidance, the catheter to the coronary arteries, and then injection of contrast agent, in the X-ray imaging after coronary artery lesions can be clear, and may provide a basis for further treatment options. Coronary angiography in patients with trauma, less pain, unknowingly in the majority of patients to complete the inspection, no obvious discomfort, all operating process only takes ten minutes. If it is found that the coronary exist narrowed or clogged and lesions appropriate, doctors can also be carried out immediately interventional treatment of vascular re unobstructed. According to the current level of technology, the very low risk of coronary angiography. Therefore, in developed countries, such examination has been widely used in a timely diagnosis of coronary heart disease, an important basis to formulate a positive and effective treatment options. Coronary angiography is still far from universal, in our country, although the level of economic and medical constraints, but more importantly, many people do not understand coronary angiography, even fear, of the symptoms of coronary heart disease and its The lack of understanding of the significance of early diagnosis and treatment. Of patients with coronary heart disease data in China is estimated to have over 20 million, while the annual coronary angiography in patients with only 70,000 to 80,000 people. Visible coronary angiography in our country remains to be popular.
Interventional therapy (mainly refers stenting) for the past 20 years developed a new technology, it does not need surgery to relieve coronary artery stenosis, coronary heart disease therapy has now become one of the important means. Coronary intervention technology mainly includes balloon angioplasty and stenting, specific practices are by the side of the femoral artery or radial artery puncture, will be equipped with the balloon catheter inserted into the body, in the X-ray fluoroscopic guidance, the stent system served stenosis, the balloon pressure in vitro expansion of the stent expansion release distraction stenosis or blockage of blood vessels and the delivery system exits the ring of vascular elastic recoil pressure so the stent firmly attached to the vessel lumen restore patency. It can relieve myocardial ischemia, eliminate angina and other symptoms, and avoid the occurrence of cardiovascular events such as myocardial infarction. This method is also used for the emergency treatment of acute myocardial infarction. Carried out in China, due to the success of the emergency surgical intervention, and mortality from acute myocardial infarction in a large medical center, 10% down to less than 5%. Compared with medical therapy, interventional therapy to alleviate angina effect more precise; compared with surgical bypass surgery, interventional treatment of trauma, low-risk patients recover quickly. Over the past 20 years, percutaneous coronary intervention broadly experienced three stages of development, the initial use of balloon dilation, narrowing or blockage of the coronary artery patency, due to elastic recoil and chronic contraction of the blood vessels, restenosis within 6 months after surgery The incidence of up to 40%. Stenting effectively prevent vascular recoil and contraction, the restenosis rate was significantly reduced stent due to stimulation of vascular smooth muscle cell hyperplasia, postoperative restenosis rate is still around 20%, so a lot of had to repeat intervention. Drug-eluting stents (eg, paclitaxel-eluting stents, rapamycin-eluting stent) applications in the past two years, is a breakthrough for interventional treatment of coronary heart disease. The use of drug-eluting stents, the drug can effectively inhibit stent-induced intimal hyperplasia reaction, so that vascular restenosis rate dropped below 9%.
The majority of patients with coronary heart disease and their families pleased that the clinical application of the drug-eluting stent for the treatment of the latest technology to intervene on behalf of coronary heart disease, our basic synchronization with the developed countries. Although the annual number of interventional treatment of coronary heart disease patients to much less than in developed countries, but in some of our medical center, the treatment success rate has reached the international advanced level. Many of our hospitals are above the level of its percutaneous coronary intervention, to complete the number of interventional treatment of patients with an annual increase rate of 30% to 40% growth.