摘要
目的比较经桡动脉与经股动脉入径行急诊经皮冠状动脉介入(PCI)治疗ST段抬高型急性心肌梗死(STEMI)的有效性及安全性。方法选择接受急诊PCI的STEMI患者112例,其中桡动脉组77例,股动脉组35例,比较两组手术成功率、介入治疗术中、术后相关指标、并发症发生率及6个月的随访结果。结果两组手术成功率均100%,处理梗死相关血管所需的指引导管数[(1.12±0.23)根vs.(1.08±0.34)根]、穿刺至球囊扩张时间[(42.34±1.23)min vs.(48.18±2.34)min]、术中球囊数[(1.21±0.32)个vs.(1.18±0.25)个]、术中支架的使用数[(1.15±0.37)个vs.(1.16±0.21)个]、造影剂用量[(98.32±8.51)ml vs.(95.45±7.23)ml]差异无统计学意义,血管穿刺相关并发症中桡动脉组发生皮下血肿伴局部皮肤水疱8例,比股动脉组发生穿刺部位血肿13例少(P<0.05);桡动脉组无血管迷走反射发生,股动脉组在术后拔管压迫止血中发生血管迷走神经反射5例;桡动脉组有1例导尿,股动脉组6例术后行导尿;住院天数桡动脉组明显较股动脉组少[(7.45±0.61)d vs.(8.39±0.53)d,P<0.05];住院期间桡动脉组因泵衰竭死亡1例,恶性心律失常猝死1例,股动脉组因泵衰竭死亡1例;术后6个月门诊或电话随访期间两组均无MACE以及靶血管再次血运重建发生。结论经桡动脉与经股动脉入径行急诊PCI治疗STEMI均有效、安全,但前者可以明显减少血管并发症、血管迷走神经反射和导尿的发生率,缩短平均住院日。
Objective The purpose of this study was to evaluate safety and efficacy of percutaneous coronary intervention（PCI） via the radial artery or via the femoral artery in treating the acute myocardial infarction with ST elevation（STEMI）.Methods PCI was performed on 112 consecutive STEMI patients either via the radial artery（n=77） or via the femoral artery（n=35）,the correlated index post the procedures,the achievement ratio and the occurrence of the complications were compared between both groups.Results All operations were successfully performed without severe complications in the two groups.There was no significant difference on the number of guiding catheters used in both groups（1.12±0.23 vs 1.08±0.34）,the operation time from arteriopuncture to saccule expanding（42.34±1.23 vs 48.18±2.34 min）,saccules（1.21±0.32 vs 1.18±0.25） or stents（1.15±0.37 vs 1.16±0.21） applied and contrast agent（98.32±8.51 vs 95.45±7.23ml）.However,there were fewer vascular-correlated complications occurred with 8 cases（8/77） of hematoma correlated with arteriopuncture in the radial artery group,in comparison with 13 cases（13/35） in the femoral artery group including 1 case of false aneurysm（P0.05）.There were 5 cases（5/35） of vasovagal reflex occurred in the femoral artery group after the procedure,but no one in the radial artery group（P0.05）.There were fewer urethral catheterizations,i.e.1 case（1/77） in the radial artery group and 6 cases（6/35） in the femoral artery group needed after the procedure.Inpatient time was also reduced（7.45±0.61 vs 8.39±0.53 days,P0.05）in the radial artery group.In both group,MACE was not found and no revascularization in the target vessel was needed during the follow up for 6 months.Conclusion PCI via femoral artery are both effective and safe in treating STEMI,but PCI via radial artery is correlated with fewer vascular complications,occurrence of vasovagal reflex.
出处
《中国临床保健杂志》
CAS
2012年第4期352-355,共4页
Chinese Journal of Clinical Healthcare
关键词
心肌梗死
血管成形术
经腔
经皮冠状动脉
桡动脉
股动脉
急诊处理
Myocardial infarction
Angioplasty
transluminal
percutaneous coronary
Radial artery
Femoral artery
Emergency treatment.
