老年冠心病经桡动脉与股动脉途径介入治疗的对比研究

目的 评价老年冠心病经桡动脉穿刺介入治疗的安全性及疗效.方法 选择2007年3月～2009年5月60岁以上老年冠心病患者314例行冠状动脉介入治疗,按穿刺途径随机分成桡动脉组(n=157)和股动脉组(n=157),观察两组间手术成功率、动脉穿刺时间、手术操作时间、x线曝光时间、外周血管并发症和术后肺栓塞发生情况.结果 经桡动脉穿刺途径成功共149例,经股动脉穿刺途径成功共152例.两组间手术成功率、X线曝光时间、手术时间等比较,差异无显著性(P>0.05).动脉穿刺时间桡动脉组明显多于股动脉组(P<0.05),外周血管并发症桡动脉组明显少于股动脉组(P<0.05),在股动脉组术后肺栓塞发生2例,而桡动脉组0例.总介入治疗手术成功率为98.1%(308/31 4).结论 只要规范化操作,老年冠心病经桡动脉穿刺介入治疗方法安全、有效且可行,术后外周血管并发症发生少.

Radial versus femoral approach for percutaneous coronary interventional procedures in the aged

Objective To evaluate the safety and effect oftransradial artery approach for coronary intervention in the aged.Methods There were 314 cases which were more than 60 years old with coronary artery disease in hospital from Mar 2007 to May 2009, who accepted coronary intervention.They were randomly divided into Transradial group(TRA, n=157) and Transfemoral group(TRF, n=157).The success rate and time of puncture, x-ray exposure time, procedure duration, complication in puncture site and pulmonary embolism were observed in the two groups.Results 149 out of 157 cases success in TRA group and 155 cases in TRF group.The success rate was not different.The success rate of puncture,xray exposure time and procedure duration had no difference between the two groups.But the complication in puncture site and pulmonary embolism were more in TRF group than in TRA group. Conclusions Pereutaneous transradial artery approach is secure and effective for coronary intervention treatment in the aged and has few vascular complications.