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各位朋友：

大家好，现在是“每天健康三分钟”时间，我是安阳道简医院的医生杨潇，今天我来给大家讲讲冠脉支架的那些事。

冠脉支架，是心脏介入手术中常用的医疗器械。简单来说，就是在堵塞的血管中，用一种细小的金属支架，撑开堵塞的血管，让血液流通。冠脉支架手术是最近 20 年来全球普遍实施的，用于改善不稳定型心绞痛、心肌梗死的核心医疗手段。在很长一段时间里，冠脉支架手术以其创伤小、痛苦小、安全系数高等优点备受患者和医生青睐，甚至在使用过程中被过分夸大疗效成为“神话”。

面对心脏支架手术逐渐被“神话”，社会乃至医学界纷纷提出批评和质疑，网上流传着各种关于冠脉支架的“谎言”：冠脉支架早被国外淘汰、冠脉支架是人体内的定时炸弹，冠脉支架会突然断裂….这些不实信息误导了很多不明真相的老百姓，造成了严重后果。在医院经常会碰到急性心肌梗死患者，本该争分夺秒立即实施急诊冠脉手术。但家属听信“谎言”，直接放弃治疗，或是心存疑虑犹豫不决，错失最佳救治机会。这让原本有机会抢救过来的患者心脏出现不可逆的损伤，迅速进展为恶性心律失常、心力衰竭,甚至猝死,严重威胁患者的生命。

无论冠脉支架是“神话”还是“谎话”，都会有治疗不足或过度治疗情况发生，最终损害的都是病人的利益。我们应该对“冠脉支架”有更加正确的认识，才能更加合理地去使用它：

1、对于稳定性心绞痛的患者，建议在改变生活方式和规范足量的药物治疗基础上，根据症状严重程度和血管狭窄的程度，充分评估权衡支架手术带来的获益和风险，再来决定是否接受支架手术。如果在药物控制下，症状没有得到缓解甚至出现加重情况，建议行PCI。

2、如果供应心肌血液的主干道——冠状动脉主干道或三支病变，多支钙化性病变等，如果行冠脉支架手术的话，可能会出现支架数量过多、支架贴壁不良等问题。建议优先考虑心脏搭桥手术。

3、当发生急性心肌梗死时，支架是救命的，时间就是心肌，不要犹豫，尽早实施急诊 PCI，可以明显改善预后，降低死亡率。

此外，要提醒大家，放置支架并不能把冠心病、心肌梗死治好，因为它既没有让斑块消除，也不能阻止斑块继续生长。改善生活方式、规范服用药物、适当合理的运动才能有效预防再狭窄，控制冠心病发展。

最后祝大家生活愉快，身体健康！想要了解更多心血管科普小知识，请关注我们，咱们下期见。

【英文版】

Popular science knowledge of coronary stent

Dear friends, nice to meet you!Now it is time for “Health talk for three minutes every day”,My name is Yang Xiao, a doctor of Anyang Daojian Hospital and Henan Zhonghui Cardiovascular Hospital.Today I'm going to tell you about the popular science of coronary stent.

Coronary stent is a common medical device in interventional surgery.Generally speaking, coronary stent implantation is to open the blocked blood vessels with a small metal stent in the blocked blood vessels, so as to let the blood flow. Coronary stent surgery is a global common practice in recent 20 years,which is used to improve the core medical means of unstable angina and myocardial infarction. For a long time, coronary stent surgery has been favored by patients and doctors for its advantages of small trauma, small pain and high safety coefficient. Sometimes, the clinical effect of coronary stent may be overestimated.

In the face of the "myth" of cardiac stent surgery,the society and even the medical community have criticized and questioned the coronary stent. There are various lies about coronary stent on the Internet, such as the early elimination of coronary stent by foreign countries, the coronary stent is a time bomb in the human body, and the coronary stent will break suddenly. These false information may mislead a lot of people who do not know the truth, resulting in serious consequences. Patients with acute myocardial infarction are often encountered in the hospital,and emergency coronary operation should be implemented immediately against the clock.However, family members listen to lies and directly give up treatment or are hesitant, resulting in patients missing the best opportunity for treatment.This makes the heart of the patients who have the opportunity to rescue have irreversible damage, and rapidly develops into malignant arrhythmia, heart failure, even sudden death, which seriously threatens the lives of patients.

Whether coronary stent is a myth or a lie, there will be under treatment or over treatment,which will ultimately damage the interests of patients.We should have a correct understanding of coronary stent in order to use it more reasonably.

For patients with stable angina pectoris,it is suggested that on the basis of changing life style and regulating sufficient drug treatment, the benefits and risks brought by stent operation should be fully evaluated and weighed according to the severity of symptoms and the degree of vascular stenosis. If the symptoms couldn’t be relieved or even aggravated under drug control, PCI is recommended.

If more than one of the main arteries that supply myocardial blood, coronary arteries or three vessels, have occurred calcified lesions, there may be problems such as excessive stent quantity and poor stent adherence when coronary stent surgery is carried out in this situation. Therefore, it is recommended to give priority to cardiac bypass surgery.

When acute myocardial infarction occurs, stent is life-saving, time is myocardial. Early implementation of emergency PCI can significantly improve the prognosis of patients and reduce mortality.

In addition, we should remind you that stent placement does not cure coronary heart disease or myocardial infarction, because it neither eliminates plaque nor prevents plaque growth. To prevent restenosis and control the development of coronary heart disease, it is necessary to improve the life style, take medicine and exercise properly.

Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.