【摘要】 目的 探讨冠状动脉介入治疗(PCI)并发冠状动脉穿孔的原因和处理方法。方法 对1991～2003年5例PCI并发冠状动脉穿孔患者的造影征象、穿孔原因、处理方法及结果进行回顾性分析。结果 穿孔血管为前降支1例、回旋支2例、右冠状动脉2例，其中C型病变4例、B型病变1例。球囊扩张或支架释放压力过大致血管撕裂2例、导丝穿出血管2例、球囊过大导致血管破裂1例;3例并发心包填塞。2例行球囊长时间低压扩张压迫、1例用支架覆盖、2例行心包穿刺引流。无死亡，无Q波性心肌梗死及急诊冠状动脉搭桥者。结论 冠状动脉穿孔是PCI少见并发症、但可导致严重临床后果，及时诊断、积极处理是减少恶性心脏事件的关键。

    关键词 冠状动脉疾病 血管成形术 并发症

    Management of coronary artery perforation during percutaneous coronary intervention

    Shen Dong，Huang Dangsheng，Luo Beijie，et al.

    Department of Cardiology，The304Hospital of PLA，Beijing100037.

    【Abstract】 Objective To investigate the cause and therapeutic method of coronary artery perforation during percutaneous coronary intervention(PCI). Methods To analyze retrospectively the angiographic appearance，cause，treatment，and outcome of coronary artery perforation complicating PCI in five patients between 1991 and 2003. Results Two of the perforations were in right coronary artery ......