经桡动脉冠状动脉介入治疗在基层医院的临床应用

目的评价经桡动脉途径进行冠状动脉介入治疗的疗效、安全性及在基层医院的临床应用价值。方法经桡动脉途径对955例冠心病患者行冠状动脉介入治疗,观察其临床疗效及血管并发症。结果对955例1 630支冠状动脉病变内置入2 610枚支架,其中置入前降支1 418枚,右冠状动脉836枚,回旋支334枚,左主干22枚,置入支架直径为2.5～4.0 mm,长度为8～36 mm。置入后经冠状动脉造影证实狭窄消失,即刻效果良好,由术前狭窄（86.7±8.4）%减至术后残余狭窄（5.8±4.6）%,支架置入成功率97.4%。并发症：20例出现桡动脉闭塞,10例出现血肿,8例术后出现前臂疼痛,死亡1例。结论经桡动脉途径进行冠状动脉介入治疗不需卧床,患者损伤小,止血方便,血管并发症少,是一种安全、有效的介入治疗方法。

Transradial approach for percutaneous coronary intervention in grass roots hospital

Objective To evaluate the safety, efficacy and clinical value of transradial approach for percutaneous coronary interven- tion in grass roots hospital. Methods The clinical efficacy and vascular complication after coronary intervention by transradial approach were observed in 955 patients with coronary heart disease. Results Intracoronary stent implantation was performed in 955 cases with 1 630 branches of coronary artery lesions by using total of 2 610 stents. 1 418 stents were implanted in left anterior desending, 836 stents in right coronary artery, 334 stents in left circumflex, and 22 stems in left main coronary artery. The stent diameter was 2.5 ± 4.0mm, stent length was 8 - 36mm. Immediate postoperative coronary angiography showed satisfactory effects. The mean diameter stenosis before angioplasty was （ 86.7±8.4） %, residual stenosis following intervention was （ 5.8 ± 4.6） %. The success rate of stent implantation was 97.4%. The complications included 20 cases with transradial occlusion, hematoma in 10 cases, arm ache in 8 cases, 1 case died. Conclusion Transradial approach for percutaneous coronary intervention is a safe and effective approach, the patient did not need to be kept in bed, the damage was small, the bleeding was easily controlled, vessel complications were less.