经桡动脉途径行冠状动脉介入治疗618例分析

目的:通过对比桡动脉、股动脉2种途径行冠状动脉介入治疗的临床疗效,探讨经桡动脉途径行冠状动脉介入治疗的安全性和有效性。方法:连续入选2003年12月至2009年12月在北京丰台医院心内科行冠状动脉介入治疗的患者1236例,随机分为桡动脉组618例,股动脉组618例,主要观察指标包括:手术成功率、穿刺成功率、血管开通时间、X线透视时间、手术总时间、不同指引导管的使用率、术中不良事件(包括死亡、急性心肌梗死、恶性心律失常、冠状动脉痉挛、夹层及穿孔和闭塞)、术后不良事件(包括死亡、急性心肌梗死、患侧肢体假性动脉瘤及血肿)及总住院时间等。结果:经桡动脉途径行冠状动脉介入治疗术的成功率为95.8%,与股动脉组比较,桡动脉组穿刺成功率、血管开通时间、X线透视时间、手术总时间差异无统计学意义。与股动脉组相比较,桡动脉组术后血肿的发生率、住院时间显著减少。结论:经桡动脉途径行冠状动脉介入治疗术安全有效,并发症少,减少了患者住院时间,但需要熟练掌握手术技巧,术中宜直接选择支撑力较好的指引导管,以提高手术成功率。

Transradial approach for percutaneous coronary interventions in 618 cases

Objective：Objective：To evaluate the clinical efficacy and methodology of percutaneous coronary intervention via radial approach. Methods：From December 2003 to December 2009,618 patients who received transradial PCI in Fengtai hospital were included in this analysis,618 patients underwent PCI via femoral artery were selected as control group . Primary endpoints included success rate of puncture procedure and PCI, time of artery cannulation,procedure duration time,the total procedure time,and local puncture complications （such as death,acute myocardial infarction,malignant arrhythmia,acute coronary artery spasm and local puncture complications）were compared between the 2 groups. Results：The success rate of puncture procedure and PCI,time of artery cannulation,procedure duration time,the total procedure time were similar between the 2 groups. The local puncture complications,medical expenditure and the admission time of the radial group were significantly lower than femoral group. Conclusion：The results suggest that PCI via radial approach is safe and effective,with few complications and this procedure could decrease the medical expenditure and shorten the admission time.