经桡动脉和股动脉途径行冠状动脉造影和介入治疗的比较  

Comparison of Coronary Angiography and Percutaneous Coronary Intervention via Radial and Femoral Approaches

作　　者：伍旭升[1] 许澎[1] 张高峰[1] 朱淑贤[1] 乔祺[1] 倪岚[1] 沈骁亮[1] 陈飞[1] 程黎[1] 

机构地区：[1]复旦大学附属上海市第五人民医院心内科,上海200240

出　　处：《中国临床医学》2007年第3期281-283,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:比较经桡动脉和股动脉两种途径行冠状动脉造影和介入治疗(PCI)的优劣,评价经桡动脉途径的安全性、可行性。方法:选择2004年1月-2007年2月行冠状动脉造影检查及介入治疗的338例患者为研究对象,按途径分为两组,桡动脉组153例,男性102例,女性51例,平均年龄63±11岁;股动脉组185例,男性131例,女性54例,平均年龄64±12岁,比较两组手术成功率、并发症发生率、手术操作时间和住院时间。结果:桡动脉组和股动脉组造影成功率分别为96.7%、98.9%(P>0.05);曝光时间分别为8′54″±4′30″,6′45″±3′38″(P>0.05)。PCI的成功率分别为98.0%、98.9%(P>0.05);曝光时间分别为16′30″±7′20″,18′49″±4′30″(P>0.05)。严重并发症(死亡和急诊冠脉旁路移植术)两组无区别,桡动脉组2例(1.3%)死亡,2例(1.3%)血肿,1例(0.7%)出现右侧桡动脉闭塞,1周后桡动脉搏动恢复;股动脉组局部出血总发生率为10.2%(19例),发生排尿困难需留置导尿18例(9.7%),拔管时迷走反射6例(3.2%)。死亡1例(0.5%)。两组住院时间分别为2.3±1.3 d和3.5±1.1d,桡动脉组住院时间较短(P<0.05)。结论:与股动脉途径相比,经桡动脉途径行冠状动脉造影和介入治疗术后并发症少,住院时间短,患者依从性高,是一种安全、有效的方法,值得推广。Objective：To evaluate the advantages and disadvantages of coronary angiography （ CAG ） and percutaneous coronary intervention （ PCI ） via radial and femoral approaches. Methods：338 patients treated with CAG and/or PCI in our hospital from January 2004 to February 2007 were divided into two groups radial approach group （n = 153 male 102 female 51. average 63 ± 11 years old ） and femoral approach group （n = 185 male 131 female 54 average 64 ± 12 years old ）. The success rate, complication rate, operating time and length of stay were compared and analyzed statistically. Results： The success rate （96.7% vs 98.9% ,P〉0.05 ） and the operating time [（8′54″±4′30″） vs （6′45″±3′38″）, P〉0. 05] of CAG. the success rate （98.0% vs 98.9, P〉0.05 ） and the operating time [（16′30″±7′20″） vs （ 18′49″±4′30″）, P〉0.05] of PCI. There was no difference between two groups regard of severe complication （death and emergency CABG） in radial group. There are 2 cases of dieing （1.3 % ） ,2 cases of hemetoma （1.3 % ） and 1 case radial artery obstruction （re-perfusion after one week ）. While in femoral group, there are 19 cases （10.2%） of local hemorrhage,18 cases （9.7%） of difficult urine need foleys drainage, 6 cases salfering to vague refler, lease of dieing. With regard to LOS （length of stay ）, it took 2.3 ± 1.3 day in radial group and 3.5 ± 1.1 day in femoral group （P〈0.05）. Conclusion：There are less complications,shortern LOS, higher compliance performing CAG as comparison with trans-femoral artery approach is safe and efficiency trans -radial artery CAG and PCI. The method is worth recommending.

关 键 词：桡动脉 股动脉 冠状动脉造影 经皮冠状动脉介入术 

分 类 号：R543[医药卫生—心血管疾病]