经桡动脉途径急诊介入治疗ST段抬高急性心肌梗死的临床研究

目的观察经桡动脉途径急诊经皮冠状动脉介入（PCI）治疗ST段抬高的急性心肌梗死（STEMI）的临床疗效及可行性。方法选择因STEMI行急诊PCI治疗的患者共计225例，其中经桡动脉组123例，经股动脉组102例。比较2组患者介入治疗的疗效和术后并发症的发生率。结果2组患者在年龄、性别、体质指数、冠状动脉粥样硬化性心脏病的危险因素、心肌梗死的部位、血管病变的位置、严重程度等方面比较，差异均无统计学意义；股动脉组PCI成功率为92．3％，桡动脉组为94．3％，2组之间差异无统计学意义（P〉0．05）；桡动脉组术后并发症发生率（6．5％）明显低于股动脉组（15．7％，P〈0．05）；2组之间平均住院时间及住院期间主要心血管事件发生率差异无统计学意义。结论急诊经桡动脉PCI治疗STEMI与经股动脉途径成功率相似，而术后并发症少，值得临床推广应用。

Feasibility and safety of transradial percutaneous coronary intervention for ST-segment elevation myocardial infarction

Objective To observe the feasibility and safety of transradial percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction(STEM I). Methods Two hundreds and twenty-five patients with identified STEMI were admitted for emergency PCI from January 2005 to December 2007. Patients were randomized into transradial group (n = 123) and transfemoral group (n = 102). Successful PCI ratio and post-operational complication were recorded and analyzed. Results There was no significant difference between the two groups in age, gender, body mass index, coronary risk factors, territory of MI, culprit vessels, and vascular stenosis degree. Meanwhile the successful PCI ratio did not differ between transradial and transfemoral groups (94.3% vs 92.3%, P > 0.05). There was a significant decrease of post-operational complication in transradiat group compared with transfemoral group (6.5% vs 15.7%, P < 0.05) although the length of hospital stay and the in-hospital main cardiovascular events did not differ. Conclusion Transradial PCI for STEMI is feasible and safe with the similar achievement ratio and decreased post-procedural complication.