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经桡动脉和股动脉途径行冠状动脉介入治疗的对比分析
引用本文:白启才,崔丽萍,李珍珍,董学庆,郭凯,杨庭树.经桡动脉和股动脉途径行冠状动脉介入治疗的对比分析[J].中华老年心脑血管病杂志,2010,12(5).
作者姓名:白启才  崔丽萍  李珍珍  董学庆  郭凯  杨庭树
作者单位:解放军总医院心内科,北京,100853
摘    要:目的对经桡动脉和股动脉途径行PCI患者的临床资料进行对比分析。方法选择行PCI的患者1011例,分为桡动脉组(355例)和股动脉组(656例),分析比较2组的手术成功率和手术并发症。结果桡动脉组和股动脉组患者手术成功率差异无统计学意义(97.7% vs 99.2%,P0.05)。2组患者1、2和3支病变行PCI时,手术和透视时间比较,差异无统计学意义(P0.05)。与股动脉组比较,桡动脉组患者复杂病变和慢性闭塞病变行PCI时,手术和透视时间明显延长,穿刺局部血肿明显降低(P0.05)。结论经桡动脉途径和股动脉途径行PCI疗效相似,但经桡动脉途径并发症少,复杂病变和慢性闭塞病变行PCI时选择经股动脉途径优于桡动脉途径。

关 键 词:桡动脉  股动脉  经皮冠状动脉介入治疗  肝素  手术后并发症

Comparison of percutaneous coronary intervention by transradial and transfemoral approaches
Abstract:Objective To evaluate percutaneous coronary intervention (PCI) by transradial and transfemoral approaches.Methods 1011 patients undergoing PCI were divided into transradial group and transfemoral group.The success rate,outcomes and complications of the operation were compared between the two groups.Results The success rate of transradial and transfemoral procedures had no significant difference.The operation time and X ray exposure time had no significant difference between the two groups undergoing PCI for 1,2 and 3 vessel lesions.The operation time and X ray exposure time were significantly longer in transradial group than in transfemoral group undergoing PCI for complex lesion or CTO lesion.The incidence rate of access site complications including hemorrhage and hematoma was significantly lower (P < 0.05) in transradial group.Conclusion Transradial and transfemoral PCI can be successfully performed with excellent safety and effectiveness.There are fewer complications by the transradial approach.For complex lesions or CTO lesions,PCI by transfemoral approach is superior to transradial approach.
Keywords:radial artery  femoral artery  percutaneous coronary intervention  heparin  postoperative complications
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