急性心肌梗死患者经股动脉和桡动脉途径行介入治疗术的临床对比观察与护理

目的 比较在经皮腔内冠状动脉成形术中采用桡动脉和股动脉2种途径行冠状动脉造影术（CAG）和冠状动脉介入治疗（PCI）的临床疗效如舒适度、并发症及护理体会.方法 选择在我院治疗的48例急性心肌梗死患者按介入途径分为2组,经桡动脉介入的23例患者为桡动脉组,经股动脉介入的25例患者为股动脉组.对2组患者术后并发症及成功率进行比较.结果 股动脉组皮下淤血2例,神经反射性低血压1例,刺激部位血肿1例,有腰酸背疼感20例,夜眠差15例,烦躁不安5例,尿潴留3例,术侧肢体肌肉痉挛4例;桡动脉组动脉闭塞1例,夜眠差3例.股动脉组成功率为100%（25/25）,桡动脉组成功率为95.7%（22/23）,其1例因桡动脉闭塞而改为股动脉后穿刺成功,2组比较差异有统计学意义（P＜0.05）.结论 经桡动脉途径行冠状动脉介入治疗较经股动脉行冠状动脉介入治疗更安全、有效,值得广泛应用.护理过程中,做好术前、术中、术后的严密观察,采取有效护理措施,可有效地减少手术并发症及不良反应.

Clinical observation and nursing of AMI patients receiving transradial PCI and transfemoral PCI

Objective To observe the therapeutic effect of coronary angiography (CAG) and Percutaneous coronary intervention (PCI) via femoral and radial arteries of percutaneous transluminal coronary angioplasty (PTCA) and the nursing strategy after therapy. Methods Totally 48 patients were divided into two groups: Radial artery groups (23 patients) and Femoral group (25 patients). The postoperative comfort, complications, the compared clinical observation and nursing care were observed. Results There were 2 cases of subcutaneous ecchymosis of femoral artery, 1 case of reflex hypotension, 1 case of stimulation hematoma, 20 cases of backache and soreness of waist,15 cases of insomnia, 5 cases of irritability, 3 cases of urinary retention and 4 cases of muscle spasms of the surgery limb. In Femoral group, there were 1 case of artery obliteration and 4 cases of insomnia. There were significant differences of all the statistics between the two groups (P < 0.05). Conclusions Transradial PCI is more safe and effective than transfemoral PCI. Perioperative observation and nursing strategies can effectively reduce the complications and adverse reactions.