经桡动脉和股动脉途径行冠状动脉介入诊治的比较分析

目的探讨经桡动脉和股动脉途径行冠状动脉介入治疗的可靠性和安全性。方法对2004年9月至2009年2月189例成功行冠状动脉造影(CAG)检查和(或)冠状动脉成形术(PCI)患者的临床资料和手术过程进行回顾性分析,按经动脉途径不同分为两组,A组(n=105例)为经桡动脉途径,B组(n=84例)为经股动脉途径,比较经桡动脉和股动脉途径两种穿刺方法的优缺点及并发症的发生率。结果两组在操作过程中平均穿刺时间、手术耗时、X线照射时间及造影剂使用量比较,差异无统计学意义(P0.05);A组并发症、不适反应等发生率显著低于B组,差异有统计学意义(P0.05);动脉痉挛A组1例,B组0例;局部血肿A组2例,B组0例;假性动脉瘤、动静脉瘘、血栓栓塞A组为0例,B组分别为4、1、1例,但两组差异无统计学意义(P0.05);腰痛及排尿困难A组显著低于B组,差异有统计学意义(P0.05)。结论经桡动脉途径与传统经股动脉途径相比,并发症少,安全可行,值得推广。

A comparison in coronary intervention diagnosis and treatment by radial and femoral approaches

Objective To explore the security and feasibility of percutaneous transradial artery approach for percutaneous coronary interventions.Methods 189 patients with coronary heart disease were enrolled in our hospital,and received the coronary intervention treatment through radial（n=105） and femoral arteries（n=84） between September,2004 and February,2009.To retrospectively analyze their clinical data and surgical procedures.The incidence rate of entry site complications,rate of discomfort occurrence and X-ray exposure time,etc.were compared between the two groups.Results There were no differences in the average puncture time,operating tim,use of contrast agents,X-ray exposure time and the incidence of vasospasm （P〉0.05）,while the incedence rate of entry site complications and rate of discomfort occurrence in the radial artery group were lower than those in the femoral artery group（P〈0.05）.Local hematoma,pseudoaneurysm,arteriovenous fistula,thromboembolism,etc.had no statistic differences between the two groups（P〉0.05）.Conclusion Percutaneous transradial artery approach is secure and feasible for coronary intervention treatment with few vascular complications.