王欣

摘要：目的：研究分析冠状动脉严重钙化病变使用血管内超声指导下冠状动脉旋磨术治疗的临床护理方式，提升护理的水平，节约手术时间，减少不良事件的几率。方法：2019年10月至2021年5月我院对18例手术患者进行了分析，对患者的护理配合进行总结归纳。结果：冠脉造影有13例被证实，准确率是72.2%，3例（16.7%）为双支病变，左主干+三支病变2例（11.1%）。患者接受手术治疗的成功率是100%，有1例血管痉挛慢血流，有2例心率血压降低，采取对症措施后，能够治愈，没有不良事件发生。结论：血管内超声指导下冠状动脉旋磨手术比较困难，手术时间长，很容易出现并发症，导管护士需要专业扎实，心理素质过硬，能够配合手术，缩短手术时间。

关键词：冠状动脉旋磨术;血管内超声;护理配合

[Abstract]Objective：To study and analyze the clinical nursing methods of coronary artery grinding under the guidance of intravascular ultrasound in the treatment of severe coronary artery calcification，improve the level of nursing，save operation time and reduce the probability of adverse events. Methods：from October 2019 to may 2021，18 cases of surgical patients in our hospital were analyzed，and the nursing cooperation of patients was summarized. Results：13 cases of coronary angiography were confirmed，the accuracy rate was 72.2%，3 cases（16.7%）were double vessel disease，2 cases（11.1%）were left main artery + three vessel disease. The success rate of surgical treatment was 100%. There was 1 case of vasospasm with slow blood flow，2 cases of heart rate and blood pressure decreased. After taking symptomatic measures，it was cured，and no adverse events occurred. Conclusion：it is difficult to operate under the guidance of intravascular ultrasound. The operation time is long，and complications are easy to occur. Catheter nurses need to be professional and have excellent psychological quality to cooperate with the operation and shorten the operation time.

[Key words]coronary artery grinding;Intravascular ultrasound;Nursing cooperation

血管內超声（intravascular ultrasound，IVUS）与冠状动脉旋磨术（Dereutaneous transluminal coronary rotational atherectomv，PTCRA）在心导管室的使用越来越频繁。RVUS可以反映血管内腔的大小，对旋磨效果进行评价。PTCRA从出现以后，使用旋磨能够将冠脉内的斑块，钙化和纤维化病变清除，让管腔扩大，然后使用球囊扩张可以避免高压扩张导致的血管损伤【1】。联合下行药物支架植入，可以更好的治疗。本文就IVUS指导下PTCRA的护理情况进行分析。

1临床资料

1.1一般资料：2019年10月至2021年5月我院对18例冠心病患者进行分析，有7例女性和11例男性患者，最小48岁，最大79岁，平均（63.2±6.8）岁。

1.2手术方法：

1.2.1 IVUS检查：使用美国Boston Scientific H7491LAB220CARTO型号超声成像仪检查，严重堵塞的情况先使用导丝引导，如果无法通过IVUS，则直接使用PTCRA。然后对旋磨效果进行评估，选择合适的药物洗脱支架尺寸。……