经桡动脉穿刺冠状动脉介入治疗在老年急性冠状动脉综合征患者中的应用  

Transradial coronary angioplasty in the elderly with acute coronary syndrome

作　　者：马礼坤[1] 余华[1] 冯克福[1] 陈鸿武[1] 夏铭蔚[1] 孙建琦[1] 韩晓萍[1] 叶琪[1] 郑丽梅[1] 

机构地区：[1]安徽医科大学附属省立医院,安徽省立医院心内科,合肥230001

出　　处：《中国临床保健杂志》2008年第4期347-349,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的观察老年急性冠状动脉综合征(ACS)患者经桡动脉穿刺途径冠状动脉介入治疗(PCI)的可行性、近期疗效及并发症的发生情况。方法选择年龄70岁以上因ACS住院接受PCI术的老年患者,术前经检查桡动脉搏动良好,Allen试验阳性,适宜行桡动脉置管,并选择经桡动脉穿刺PCI者51例为桡动脉组,对照组97例为同时期年龄70岁以上采取经股动脉穿刺PCI的ACS者(股动脉组)。观察两组PCI成功率和近期临床疗效以及与穿刺有关的并发症的发生率,记录和统计患者术后绝对卧床时间和住院天数。结果两组血管病变特征基本相同。桡动脉组PCI的成功率为94.1%,股动脉组为96.9%,两组相比差异无统计学意义(P>0.05)。术中造影剂用量和X线曝光时间两组差异无统计学意义(P>0.05)。术后随访两组心功能和主要心血管事件发生率差异无统计学意义(P>0.05)。但与穿刺有关的并发症的发生率桡动脉组(2.0%)显著低于股动脉组(21.7%)(P<0.01)。桡动脉组术后平均绝对卧床时间和平均住院天数均明显短于股动脉组(分别P<0.01和P<0.05)。结论与经股动脉穿刺相比,老年ACS患者经桡动脉穿刺途径PCI具有相同的疗效,但术后患者卧床时间短,恢复快,与穿刺有关的并发症明显减少。Objective To investigate the success rates and complications of transradial coronary angioplasty in elderly patients with acute coronary syndrome （ACS）. Methods 51 old elderly ACS patient, aged more than 70 years, who admitted to receive percutanous coronary intervention （PCI） therapy were selected to transradial approach according to the Allen test results. The success rates and its complications, and main cardiac events during one month follow-up were recorded, and compared with the results of transfemoral angioplasty in 91 elderly ACS patients. Results The success rates of PCI was 94.1% in 51 cases of transradial group compared with 96.9% in 97 cases of transfemoral patients （ P 〉 0. 05 ）, and the main cardiac events during follow-up period were comparable between two groups （P 〉 0. 05）. In transradial group, the average usage of contrast and X-ray expose time for each patient were same as the transfemoral group（P 〉0. 05）. But the rate of total complications related to puncture in transradial group was less than transfemoral group （2.0% vs 21.7%, P 〈0. 01 ）, and the average times of stay in bed and hospitalization after PCI were less than that in transfemoral group also （P 〈 0. 01, P 〈 0. 05 ） ）. Conclusions In elderly patients with ACS, tranradial coronary angioplasty has the same success rate, but less complication related to puncture and stay in bed for relatively less time after procedure compared with transfemoral approach.

关 键 词：冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 桡动脉 股动脉 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]