ABSTRACT
Objective To investigate the efficacy and cardiovascular disease of Danhong injection in the treatment after cardiac interventional therapy.Methods A total of 64 cases with cardiac intervention from September 2013 to July 2015 in our hospital were selected and divided into control group and experiment group with 32 cases in each group.Patients in the control group were given aspirin 100mg orally,and patients in the experiment group revieved Danhong injection 20mL intravenous drip qd,one times a day for 14 days.Two groups of patients underwent cardiac intervention.After the operaiton,the control group was given aspirin enteric-coated tablets 100mg orally,clopidogrel 75mg orally,and patients in the experiment group revieved Danhong injection 20mL intravenous drip qd,seven days for a course and the patients treated for three courses.The clinical efficacy,C-reactive protein(CRP),cardiac troponin T(TnT),P-selectin(Ps),PSGL-1,cardiovascular events(cardiovascular events),and adverse events were compared.Results After treatment,the clinical efficacy in experiment group was 93.75％,which significant higher than that in control group 71.88％,the difference was statistically significant(P<0.05).The rate of cardiovascular events in experiment group was 21.88％,which significant lower than that in control group 40.63％,the difference was statistically significant(P<0.05).The serum C-reactive protein,troponin T,Ps and PSGL-1 were significantly decreased in the two groups,and the experimental group was significantly smaller than the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions was 15.63％in the control group and 9.38％in the experimental group,the difference was not statistically significant.Conclusion Danhong injection treatment of elderly patients with cardiac intervention after the clinical effect is significant,high security,the incidence of cardiovascular events is low.
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Objective To measure the peak skin dose (PSD) in two cardiovascular interventional procedures,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) using radiochromic film.Methods Gafchromic XR-RV3 film was selected to measure PSD in two hospitals.The films were placed on the table underneath the patient during interventional surgery.The kV,mA,fluoroscopy time,dose-area product (DAP),and cumulative dose at reference point and other relevant information were recorded for all cases.Using the Epson V750 flatbed scanner for scanning and analyzing film,FilmQA software was chosen to analyze the pixel value of red,green and blue color channels.The PSD was determined using red channel data.The correlation and linear regression analysis between PSD and device-displayed parameters was carried out.Results PSD were measured using XR-RV3 film for 26 CA and 19 CA + PTCA procedures.For CA procedures,maximum fluoroscopy time,cumulative dose and DAP were 17.62 min,1 498.50 mGy and 109.68 Gy · cm2,respectively.The maximum PSD was 361.20 mGy.However,for CA + PTCA procedures,maximum fluoroscopy time,cumulative dose and DAP were 64.48 min,6 976.20 mGy and 5 336.00 Gy· cm2,respectively.One patient with CA + PTCA procedures was found to have received the PSD value more than 2 Gy,up to 2 195.70 mGy.DAP was found to be a good indicator (R2 =0.815,P ＜0.05) of PSD for CA procedure,and correlated with cumulative dose (R2 =0.916,P ＜ 0.05) for CA + PTCA procedures.Conclusions The PSD value of some patients in cardiac interventional procedures would exceed 2 Gy,the threshold of deterministic effects recommended by ICRP.The dose-related parameters value showed on DSA device can only used to estimate PSD roughly.Using XR-RV3 film accurate measurement of the PSD in interventional projects is a very fast and effective method.
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Objective To observe the imaging features of coronary sinus (CS) and its tributaries in Chinese by using multislice computed tomography (MSCT).Methods One hundred patients [74 men,26 women,average age (58.10?1.78)] were scanned by MSCT,3D images reconstructed and the vessels courses evaluated.Results The CS and great cardiac vein (GCV),middle cardiac vein (MCV) were visualized in all patients,as well as left posterior vein (LPV) was showed only in 82 patients.The average width of CS was (1.98?0.41),(1.08?0.06)cm,and the average area was (2.144?0.37)cm~2.The diameter of MCV was (0.49?0.04) cm and its angle with CS was (73.98?5.82)?.The GCV remained in the same axis as the CS in the left atrioventricular groove,its average diameter was (0.35?0.03)cm.The LPV's average diameter was (0.33?0.05)cm and its average angle with GCV was (74.32?7.81)?.The MCV and LPV in most of the patients drained to the CS at an angle less than 90?,and this angulation might cause technical difficulties during inserting a left ventricular pacing lead.Conclusion MSCT is a simple and feasible method to visualize the imaging features of CS and its main tributaries,and in the clinical,it can be used to evaluate patient's coronary vein system before cardiac interventional procedure such as left ventricular pacing lead implantation.
ABSTRACT
Vasovagal reflex is one of complications from cardiac intervention.The major causes of vasovagal reflex postprocedure are commonly believed to be associated with mental stress,pain,low blood volume,visceral dilation,local hematoma and cardiac function.The incidence of vasovagal reflex may be effectively reduced with standard intervention training,strictly selected indications for PCI,adequate fluid replacement after procedure,anesthetic lidocaine to reduce pain,improved manual compression for vascular hemostasis and elimination of risk factors.