老年女性患者经鼻烟壶桡动脉与经典桡动脉行冠状动脉诊疗的对比性研究

目的探讨老年女性患者经鼻烟壶处桡动脉行冠状动脉造影和PCI的可行性和安全性。方法选择行冠状动脉造影和(或)PCI的老年女性患者100例,根据穿刺部位不同随机分为鼻烟壶组50例(穿刺鼻烟壶部位)及经典组50例(穿刺常规桡动脉)。观察2组穿刺时间、穿刺成功率、手术时间、手术成功率、置入支架、穿刺部位出血、血肿、动脉瘤及桡动脉闭塞率等情况。结果 2组血管内径、穿刺时间、穿刺成功、手术成功、手术时间、置入支架、术后血肿、动脉瘤和动静脉瘘发生率比较,差异无统计学意义(P>0.05)。鼻烟壶组桡动脉痉挛、闭塞和总并发症发生率较经典组明显降低(2%vs 8%,2%vs 10%,6%vs 20%,P<0.05)。结论老年女性患者经鼻烟壶桡动脉途径的桡动脉痉挛发生率及闭塞率更低,安全性好,可以作为常规桡动脉的替代途径应用于冠状动脉诊疗。

Transsnuffbox radial artery access and classical radial artery access for coronary artery diagnosis and treatment of elderly female patients

Objective To study the feasibility and safety of transsnuffbox radial artery access for coronary arteriography(CAG) and PCI in elderly female patients.Methods One hundred elderly female patients who underwent CAG and/or PCI in Tianjin No.3 Central Hospital were randomly divided into transsnuffbox radial artery access group(n=50) and classical radial artery access group(n=50) according to their different puncture sites.The puncture time and success rate,operation time and success rate,number of implanted stents,incidence of puncture site hemorrhage,hematoma,aneurysm and radial artery occlusion were recorded.Results No significant difference was detected in puncture time and success rate,operation time and success rate,number of implanted stents,incidence of puncture site hemorrhage,hematoma,postoperative aneurysm and arteriovenous fistula between the two groups(P>0.05).The incidence of radial artery spasm and occlusion and the total incidence of complications were significantly lower in transsnuffbox radial artery access group than in classical radial artery access group(2% vs 8%,2% vs 10%,6% vs 20%,P<0.05).Conclusion The incidence of radial artery spasm and occlusion is lower and the safety of transsnuffbox radial artery access is higher than that of classical radial artery access for CAG and PCI in elderly female patients.The transsnuffbox radial artery access can thus be used as an alternative access for CAG and PCI in elderly female patients.