摘要
目的评价经桡动脉直接介入治疗老年人急性心肌梗死的临床优势。方法收集2008年1月至2011年10月因急性ST段抬高心肌梗死施行直接介入治疗的老年患者150例，平均年龄（70．4±7．2）岁，经股动脉路径介入治疗（股动脉组）91例，经桡动脉路径介入治疗（桡动脉组）59例，比较两组的穿刺至球囊打开时间、梗死相关血管的开通成功率、X线曝光时间、总手术时间、对比剂用量、平均住院天数、平均住院费用及术后并发症。结果桡动脉组患者平均住院天数（9．3±0．5）d少于股动脉组与（12．8±0．7）d（P〈0．01）；桡动脉组的平均住院费用低于桡动脉组（44707．3±1009．3）元与（54047．8±1971．6）元（P〈0．05）；穿刺至球囊打开时间（26．7±0．8）min与（27．7±1．2）min（P〉0．05）；梗死血管开通成功率98．3％（58／59）与96．7％（88／91）（P〉0．05）；X线曝光时间（10．8±0．9）min与（9．6±0．6）min（P〉0．05）；对比剂用量（223．9±9．2）ml与（229．8±7．5）ml（P〉0．05）。两组术后外周血管并发症、住院期间心血管事件比较，差异无统计学意义（P〉0．05）。股动脉组术后无尿潴留，桡动脉组组11例，两组比较差异有统计学意义（P〈0．01）。结论在老年急性心肌梗死患者中，桡动脉组具有与股动脉穿刺相同的开通梗死相关血管的可操作性和安全性，且患者术后有更好的舒适度，降低其住院天数和住院费用，具有良好的临床优势和社会经济效益。
Objective To evaluate the clinical advantages of transradial approach for percutaneous coronary intervention in elderly patients with acute myocardial infarction. Methods From January 2008 to October 2011, 150 elderly patients （average age of 70.4 ±7.2 yrs） diagnosed with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary invention （PCI）. They were divided into transfemoral intervention group （TFI group, n= 91） and transradial intervention group （TRI group, n=59）. The arrival time at the first balloon inflation, the success rate of reperfusion, the X-ray exposure time, the total procedural time, contrast volume, the average in-hospital days, the mean hospital expenses and postoperative complications were compared between two groups. Results The average in-hospital days was shorter in TRI group than in TFI group [（9.3±0.5） days vs. （12.8±0.7） days,P〈0.01]. The mean in-hospital expenses was less in TRI group than in TFI group [（44707.3±1009.3） RMB vs. （54047.8±1971.6） RMB, P〈0.05]. There were no significant differences in the arrival time at the first balloon inflation, the success rate of reperfusion, the X-ray exposure time, the contrast volume between the two groups [（26.7 ± 0.8） minutes vs. （27.7±1.2） minutes, 98.3%（58/59） vs. 96.7%（88/91）, （10.8±0.9） minutes vs. （9.6±0.6） minutes, （223.9±9.2） ml vs. （229.8±7.5） ml, respectively, all P〉0.05]. The postoperative complications including major bleeding, pseudoaneurysm, radial occlusion without ischemia and the incidence of major adverse cardiovascular events had no statistical differences between the two groups （P〉0.05）. The eases of urethral catheterization caused by urinary retention were less in TRI group than in TFI （0 vs. 11 cases, P〈0.01）. Conclusions Compared with transfemoral approach, the transradial approach is feasible and safe for primary PCI in elderly patients with acutemyocardial infarction, and has better clinical advant
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第4期383-385,共3页
Chinese Journal of Geriatrics
关键词
桡动脉
股动脉
心肌梗死
血管成形术
Radial artery
Femoral arterg
Myocardial infarction
Angioplasty
