经桡动脉与经股动脉急诊冠状动脉介入治疗对比研究

目的 通过经桡动脉入径与经股动脉入径行急诊冠状动脉介入治疗(PCI)的对比研究,来观察急性心肌梗死(AMI)经桡动脉人径急诊冠脉介入治疗的安全性和可行性.方法 选择2008-01-2010-03我院诊断急性心肌梗死的患者52例,随机分组,经桡动脉介入组为24例,经股动脉介入组为28例,行急诊PCI治疗,观察两组手术成功率、鞘管置人时间、手术耗时和并发症发生率.结果 两组PCI成功率均为100％；手术耗时桡动脉组为(54.7±18.3) min,股动脉组为(51.5±17.2)min,两组间差异无统计学意义(P＞0.05).鞘管置人时间股动脉组少于桡动脉组,差异有统计学意义(P＜0.05),但对预后没有造成明显影响.术后并发症桡动脉组局部血肿、假性动脉瘤、迷走反射发生低于股动脉组,差异有统计学意义(P＜0.05).结论 经桡动脉人径急诊PCI是安全、有效的方法,与经股动脉人径比较,经桡动脉入径可减少并发症的发生,可作为AMI患者行急诊PCI的常规途径.

Comparative Study on emergent coronary intervention via arteria radialis or femoral

Objective To observe the safety and feasibility of emergent coronary intervention percutaneous radial in a- cute myocardial infarction（AMI） through comparative study on emergent coronary intervention via arteria radialis or femoral. Method 52 cases diagnosed AMI in our hospital and treated by PCI from January 2008 to March 2010 were divided into two groups random： radial approach group （n = 24） and femoral approach group （ n = 28 ）. The success rate, time set Sheath, operating time and complication rate were compared. Results The success rate of PCI were 100% all,the operating time was（54.7±18.3）mins in radial approach group and （51.5±17. 2） mins in femoral ap- proach group,and there was no statistical difference between two groups（P〉0.05 ）. Time set Sheath in femoral ap- proach group was shorter than that in radial approach group, and there was statistical difference（P〈 0. 05 ）, but prognosis were not effected significtly, complications after operation （Local arteria radialisaematoma, pseudoaneu- rysm. vasovagal reaction） in radial approach group was less than that in femoral approach group and there is statisti- cal difference between two groups（P〉0.05 ）. Conclusion The emergent PCI through radial approach is safe and ef- fective. The complications in radial approach group is lower compared with that in femoral approach group and it can be conventional means in emergent PCI.