急诊冠状动脉介入治疗经桡动脉入路与行血管闭合装置股动脉入路的比较研究

目的 探讨急诊冠状动脉介入治疗经桡动脉入路与经行血管闭合装置股动脉入路的有效性和安全性.方法 选取2010年1月至2012年12月在我院连续行急诊冠脉介入治疗的192例急性ST段抬高心肌梗死（STEMI）患者,依据血管入路途径将患者分为桡动脉组82例和行血管闭合装置股动脉组110例,观察疗效、并发症及住院期间主要心血管不良事件（MACE）.结果 两组临床基线资料比较差异均无统计学意义（P值均＞0.05）;两组住院期间病死率、PCI操作成功率差异均无统计学意义（P值均＞0.05）;桡动脉组PCI操作时间和Needle-to-Balloon时间较行血管闭合装置的股动脉组延长（P值均＜0.05）;桡动脉组非主要血管并发症的发生率低于行血管闭合装置的股动脉组（P=-0.016）.结论 行急诊PCI经桡动脉入路与经行血管闭合装置的股动脉入路途径相比,具有相同的MACE和住院期间病死率,因此可将其作为急诊PCI血管入路途径的选择.

Tansradial access compared with femoral puncture closure devices in primary percutaneous coronary intervention

Objective Aim to evaluate the effectiveness and safety in primary percutaneous coronary in- tervention （PCI） emp]oylng trans-radlal access （RA） or vascular closure devices （VCD） associated with trans- femoral access. Methods From January 2010 to December 2012, 192 consecutive acute ST-segment elevation myocardial infarction patients received primary PCI and were divided into RA group （n=82） and VCD associated with trans-femoral access group according to different vascular access. The therapeutic effect, complications were assessed and major adverse cardiovascular events （MACE） were evaluated during hospitalization. Results There was no statistical difference in baseline clinical characteristics between both groups（P〉0.05 ）, and neither were dif- ferences in mortality during hospitalization, procedure time and needle-to-balloon time in both groups. The non- major vascular complications in the radial group was significantly less than that in VCD associated with trans- femoral access group （P=0.016）. Conclusion Trans-radlal access compared with VCD associated with trans- femoral access during primary PCI was associated with same MACE and mortality during hospitalization, therefore, trans-radial access can be a feasible chance for primary PCI.