老年女性患者经桡动脉和股动脉途径行冠状动脉介入治疗的对比分析

目的评价老年女性患者经桡动脉和股动脉途径行PCI的安全性和临床效果。方法选择行PCI、年龄≥75岁的老年女性患者332例,按手术入径方式分为桡动脉组184例和股动脉组148例,回顾性分析患者的临床资料。冠状动脉造影检查显示,冠状动脉狭窄≥75%者行冠状动脉支架置入术。比较桡动脉和股动脉途径介入治疗临床疗效。结果 332例患者中有96例接受PCI,桡动脉组和股动脉组患者3支病变比率分别为39.7%和47.4%,分叉病变比率分别为60.3%和52.6%。与桡动脉组比较,股动脉组患者手术时间长,外周血管损伤明显增多(P0.05),术后观察时间及卧床时间明显延长,假性动脉瘤、下肢静脉血栓例数明显增多,穿刺动脉闭塞明显减少(P0.05)。结论老年女性患者自身病情复杂,选择桡动脉途径行PCI可以减少局部血管并发症,近期治疗风险小,病死率低,可取得较理想疗效。

Comparative analysis of percutaneous coronary intervention through radial artery or femoral artery approach in aged female patients

Objective To study the safety and efficacy of percutaneous coronary intervention(PCI) through radial artery and femoral artery approach in aged female patients with coronary heart disease. Methods Retrospective analysis of clinical data of 332 patients older than 75 years was done.The patients were divided into 2 groups:radial artery group and femoral artery group.Results Of the 332 patients,96 received PCI treatment.The rate of 3-vessel lesion was 39.7% and 47.4% and the rate of bifurcation lesion was 60.3% and 52.6% in radial artery group and femoral artery group respectively.Compared with radial artery group,the operation time was longer, peripheral vessel injury was significantly increased (P < 0.05),the postoperative observation time and bed-rest time were significantly prolonged,incidences of pseudoaneurysm and lower limb venous thrombosis were signifieantly increased,and incidence of punctured artery occlusion was significantly decreased (P < 0.05) in femoral artery group.Conclusions Radial approach PCI in senile women with coronary heart disease reduced the vascular complications in high-risk population. PCI improves the long-term survival rate of patients and can be done in the elderly with low mortality rate and acceptable long-term outcomes.