老年急性心肌梗死患者经桡动脉和股动脉介入治疗的对比分析

目的分析老年急性心肌梗死患者经桡动脉直接PCI治疗的成功率、并发症以及应用经验。方法选择行直接PCI治疗的老年急性ST段抬高心肌梗死患者96例,根据PCI操作途径分为桡动脉组(50例)和股动脉组(46例),比较两组的手术成功率和手术结果,分析手术并发症以及住院期间预后。结果桡动脉组和股动脉组手术成功率相似(92.0%vs91.3%,P>0.05),桡动脉组有两例患者交叉到股动脉组手术成功,两组手术时间、穿刺时间和第一次球囊扩张时间均无显著差异(P>0.05),但桡动脉组透视时间显著延长(P<0.05),住院期间主要心血管不良事件两组无显著差异,桡动脉组穿刺局部出血并发症显著降低(2.0%vs10.8%,P<0.05)。结论经桡动脉直接PCI在老年急性心肌梗死患者中有较好的安全性和有效性。

Comparative study of transradial and transfemoral intervention therapy in aged acute myocardial infarction patients

Objective To analyze safety and feasibility of transradial coronary angioplasty in aged acute myocardial infarction patients.Methods Ninety-six patients who had undergone coronary angioplasty due to acute myocardial infarction in our department were included in present study.They were divided into two groups: transradial group(n=50) and transfemoral group(n=46).The success rate,procedure characteristics,complications during operation and hospitalization,as well as major adverse events during hospitalization were compared between the two groups.Results The success rates of transradial and transfemoral PCI had no significant difference(92.0%vs 91.3%,P>0.05),but 2 patients in transradial group were transferred to transfemoral group due to severe subclavian artery tortuosity and radial artery loop.The operation time,vascular access time,first balloon dilation time had no significant difference between the two groups,but X ray exposure time was longer in transradial group than in the transfemoral group.The major adverse cardiac events were similar between the two groups,but incidences of access site complications including hemorrhage and hematoma were significantly lower in transradial group than in the transfemoral group(2.0% vs 10.8%,P<0.05).Conclusion Transradial coronary angioplasty can be successfully performed in aged acute myocardial infarction patients with excellent safety and effectiveness.