应用国产心血管造影机进行经桡动脉与经股动脉途径冠心病介入治疗的比较  

A comparative study of intervention approaches in coronary heart disease:Transradial and transfemoral by China-made cardioangiographic system

作　　者：许勇[1] 文亚红[1] 田巨龙[1] 罗晓辉[1] 徐大文[1] 钱昌明[1] 曾晓斌[1] 高红梅[1] 

机构地区：[1]攀枝花市中心医院心内科,四川攀枝花617067

出　　处：《心脏杂志》2007年第4期464-466,470,共4页Chinese Heart Journal

摘　　要：目的比较应用国产心血管造影机进行经桡动脉和经股动脉途径冠心病介入治疗（PCI）的安全性和有效性。方法我院2003年1月-2006年4月应用我国万东公司生产的大型C臂心血管造影机（CGO-3000）对290例（163例男性）冠心病患者进行经桡动脉组（n=98）或经股动脉组（n=192）途径PCI治疗,观察两组手术成功率、并发症发生率、鞘管置入时间、X线曝光时间、手术时间及造影剂用量。结果PCI总成功率99.3%,高于全国第3次PC I病例注册资料分析结果,主要并发症发生率无增多。两组病例基线水平、增加出血的危险因素、病变复杂程度、支架置入血管、支架置入数无统计学意义;两组成功率、鞘管置入时间、X线曝光时间、手术时间、造影剂用量无统计学意义;A组血肿0例（0%）、B组21例（10.9%）,A组血管迷走反射0例（0%）、B组21例（10.9%）,A组皮肤破溃、感染0例（0%）、B组11例（5.7%）,A组穿刺血管痉挛4例（4.1%）、B组0例（0%）,A组不能入睡0例（0%）、B组184例（95.8%）,A组腰背部疼痛0例（0%）、B组153例（79.7%）,A组尿潴留0例（0%）、B组63例（32.8%）,A组平均住院（4.2±0.6）d、B组（6.1±2.2）d,均P〈0.05,有统计学意义。结论经桡动脉途径是一种安全、有效、患者更容易接受的PCI方法,它与传统经股动脉途径互为补充。对有选择的病例桡动脉途径可首选。AIM To investigate the safety and effectiveness of transradial approach by China-made Carm cardioangiographic system in the treatment of coronary heart diseases by comparing the main parameters obtained from transradial approach and transfemoral approach. METHODS From January 2003 to April 2006, percutaneous coronary intervention（PCI） was performed in 290 patients （160 males） with coronary heart disease via either transradial （ Group A, n = 98 ） or transfemoral approach （ Group B, n = 192） by China-made C-arm cardioangiographic system （CGO-3000）. The success rate, the complications rate, the cannulation time, the X-ray exposure time, the operation time and the amount of contrast consumed were recorded and compared. RESULTS The overall successful rate of PCI is 99.3% , higher than that of the 3rd national registered data of intervention, and the main complications rate is not increased. Comparing this two groups, the basic line level of patients, risk factors of bleeding, lesion complication, vessel implanted with stent, and stent number show no statistic significance; the successful rate, cannulation time, X-ray exposure time, operation time, and the amount of contrast consumed have no statistic sense; the hematoma complications [ A =0（0% ） versus B =21 （ 10.9% ） ,P 〈0.05], vagus reflex complications[ A =0（0% ） versus B = 21 （10.9%）,P 〈0.05 ], skin erosion and infection complications [ A = 0 （0%） versus B = 11 （5.7 % ）, P 〈 0.05 ], puncture angiospasma complications [ A = 4 （4.1% ） versus B =0（0% ） ,P 〈0.05], insomnia complications[ A =0（0% ） versus B = 184（95.8% ） ,P 〈0.05], lumbodorsalgia[ A =0（0% ） versus B = 153 （79.7%）, P 〈 0.05 ], urinary retention complications [ A = 0 （0%） versus B = 63 （32.8%）,P 〈 0.05 ], and the average hospitalization time [ A = （4.2 ± 0.6） days versus （6.1 ± 2.2） days ,P 〈 0.05 ] show statistic significances. CONCLUSION The transradial approach, safer, more reliable and better accepte

关 键 词：经桡动脉途径 经股动脉途径 直接经皮冠状动脉介入术 国产心血管造影机 

分 类 号：R541.4[医药卫生—心血管疾病]