经桡动脉急诊PCI治疗STEMI的可行性研究

目的探讨经桡动脉急诊经皮冠脉介入（PCI）治疗sT段抬高急性心肌梗死（STEMI）的临床疗效及可行性。方法选择确诊的因STEMI行急诊PCI治疗的患者共计225例，其中，经桡动脉组123例，经股动脉组共计102例。分析比较两组患者介入治疗的成功率、疗效、手术时间和术后并发症的发生率。结果两组患者在年龄、性别、体重指数、冠心病危险因素、心肌梗死的部位、血管病变的位置、严重程度等方面比较，均无统计学差异；股动脉组PCI成功率为92．3％，桡动脉组为94．3％，两组之间无统计学差异（P〉0．05）；桡动脉组术后并发症发生率（6．5％）明显低于股动脉组（16．7％）（P〈0．05）；手术平均时间、X线平均曝光时间和Door—balloon时间两组无显著差异；平均住院时间及住院期间主要心血管事件发生率两组之间无统计学差异。结论经桡动脉途径行急诊PCI治疗STEMI与经股动脉途径PCI成功率相似，Door—balloon时间相当，而术后并发症少，值得临床推广应用。

Feasibility of transradial percutaneous coronary intervention for ST - segment elevation myocardial infarction

Objective To investigate the feasibility and safety of transradial pereutaneous coronary intervention for ST - segment elevation myocardial infarction. Methods Two hundreds and twenty - five patients with identified ST - segment elevation myocardial infarction were admitted for emergency pereutaneous coronary intervention from January 2005 to December 2007. Patients were randomly divided into transradial group （ n = 123） or transfemoral group （ n = 102）. Successful PCI ratio and post- operational complication were recorded and analyzed. Results There was no significant difference between the two groups in age, gender, body mass index, coronary risk factors, territory of MI, culprit vessels, and vascular stenosis degree. As well, the successful PCI ratio did not differ between transradial and transfemoral groups （94. 3% vs 92.3%, P 〉 0.05 ）. There was a significant decrease of post -operational complication in transradial group compared with the transfemoral group （6. 5 % vs 16. 7%, P 〈 O. 05 ）, the meantime of the operation, the time under X - ray and time of Door - ballon did not differ obviously, although the length of hospital stay and the in - hospital main cardiovascular events did not differ statistically. Conclusion Transradial pereutaneous coronary intervention for ST - segment elevation myocardial infarction was feasible and safe with the similar achievement ratio and decreased post - procedural complication.