经桡动脉入路对急性心肌梗死患者行直接PCI术临床研究  

Clinical study of PCI by radial artery approaching on patients with acute myocardial infarction

作　　者：韩雪更[1] 徐亚伟[1] 陈滟清[1] 李伟明[1] 杨海燕[1] 明强[1] 

机构地区：[1]同济大学附属第十人民医院心内科,上海200072

出　　处：《同济大学学报（医学版）》2008年第3期100-103,123,共5页Journal of Tongji University(Medical Science)

摘　　要：目的对急性心肌梗死患者经桡动脉入路行直接经皮冠状动脉血管成形术(percutaneous coronary inter-vention,PCI)的可行性及安全性探讨。方法明确诊断急性心肌梗死患者145例,分为两组,A组(桡动脉入路组)37例,F组(股动脉入路组)108例,观察两组临床基本资料、穿刺情况、病变类型、PCI术情况、手术成功率、术后及半年内并发症。结果两组临床基本资料相似,A组穿刺成功率95%,F组穿刺成功率100%,两组比较无明显差异(P>0.05),A组穿刺时间(7±8.4)min,F组穿刺时间(3±4.6)min,两组比较差异有显著性(P<0.05),梗死相关部位及病变类型无明显差异,术后平均卧床时间A组显著低于F组[(3.4±1.2)hvs(12.9±3.6)h,P<0.05]。A组术后与穿刺有关并发症发生率明显低于F组(P<0.01)。随访PCI术后半年内主要心血管事件,两组之间无明显差异(P>0.05)。结论经桡动脉穿刺对急性心肌梗死行PCI术成功率高,并发症少,尤其对高龄合并心功能不全患者减少卧床时间,减少不适症状具有可行性。Objective To assess the safety and feasibility of direct percutanous coronary intervention（PCI） by radial artery approaching on patients with acute myocardial infarction. Methods One hundred and fortyfive patients with acute myocardial infarction were divided into two groups： A group （trans-radial approach group） with 37 cases and F group （trans-femoral approach group） with 108 cases. Clinical data,puncture resuits, characteristics of target lesion, status of PCI, successful rate of operation, complication after operation and during 6 month follow-up were observed. Results The clinical baseline was similar, the successful rate of puncture was 95% in A group compared with 100% in F group （ P 〉 0.05 ）. The puncture time in A group was longer than F group [（7±8.4） min vs （ 3 ± 4.6 ） min, P 〈 0.05 ]. There were no significant differences of relative infarction and characteristic by target lesion, while the average bed-time after procedure in A group was shorter than in F group[ （ 3.4 ±1.2 ） h vs （ 12.9 ± 3.6 ） h, P 〈 0.05 ]. The ratio of relative complication on puncture and procedure in A group was lower than F group （P 〈 0. 01 ）. The major cardiovascular events （MACE） had no significant difference between two groups during 6 months following-up. Conclusion Trans-radial PCI on patients with acute myocardial infarction has a higher successful rate and less puncture relative complications. It could reduce the time of lying on bed and discomfort, especially being feasible for elder patients with congestive failure.

关 键 词：桡动脉 股动脉 经皮冠状动脉成形术 急性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]