51例经桡动脉冠状动脉腔内成形术及支架术的临床经验  

Experiences in 51 cases of transradial coronaty angioplasty and stenting

作　　者：魏盟[1] 严卫[1] 樊冰[1] 王齐冰[1] 潘翠珍[1] 戎卫海[1] 何梅先[1] 蔡乃绳[1] 陈灏珠[1] 

机构地区：[1]上海医科大学中山医院上海市心血管病研究所心内科

出　　处：《农垦医学》1999年第5期305-308,共4页Journal of Nongken Medicine

摘　　要：目的：评价国人经桡动脉冠状动脉成形术的可行性。方法：我院1998年7月至1999年2月间共行冠状动脉腔内成形术（PTCA）63例．其中51例采用经桡动脉法完成，其中男性46例．女性5例，平均年龄为60±9．6（40～80）岁。33例于术前及术后用彩色多普勤二维超声检测了右桡动脉的内径及平均血流速度。结果：术前及术后的桡动脉内径及平均血流速度无明显差别（0．26±0．04cmvs．0．25±0．03cmand55．9±18．5cm／svs．56.915.5cm／s，P均＞0．05）。共对71处病变实施了PTCA，其中A型病变30处，B型病变17处，C型病变24处，放置支架51枚，其中A型病变25处，B型病变12处，C型病变14处，最短支架为9mm，最长为40mm；最小直径为2．5mm，最大为3．5mm。所有病例均为冠脉造影后即刻行PTCA，手术成功率为92．2％（47／51），4例未成功，均为前降支完全闭塞，导丝未能通过病变。无一例转股动脉途径手术。并发症1例，为欲对右冠脉中段PTCA而指引导管进入过深造成近端血管严重夹层分离。术后未见桡动脉闭塞及血管并发症。结论：经桡动脉PTCA病人创伤小，恢复快，是进行PTCA的又一安全、可行的选择途径。Objective:To evaluate the feasibility of transradial coronary angioplasty on Chinese patients.Metho0ds:Among the 63 cases of PTCA performed in our hospital,from July, 1998 to Feb.1999, 51 patients were chosen to undertake transradial coronary angioplasty with Judkins techique.The average age of the patients was 60±9. 5,male, 46, female, 6. The inner diameters and average blood velocity of the right radial artery were measured with color Doppler echocardiograph in 33 patients before and after coronary angioplasty.Results: The diameters and the average blood velocities of the right radial artery were not changed before coronary angioplasty and after coronary angioplasty (0. 26±0. 04cmvs. 0.25±0.03cm and 55. 9±18. 5cm/s vs. 56. 9±15. 5cm/s, respectively, all P>0.05). Balloon angioplasty was performed in 71 lesions (30 type A, 17 type B,and 24 type C). 51 stents the shortst was 9mm, the longest was 40mm,the smallest in dianeter was 2. 5mm,the biggest in diameter was 3. 5mm. Procedural success was achieved in 47 patients (92. 2% ). Four cases were failed due to that the guide wires could not pass through chronic occlusive lesions of LAD.Access-related complications and occlusion of right radial arteries were not found. Only in one patient, the guiding catheaer resulted in nonfatal non-Q Wave myocardial infarction.Conclusions: transradial angioplasty and stenting are both feasible and safe with low risk of access complications and with excellent procedural success in Chinese patients.

关 键 词：冠状动脉成形 腔内成形术 桡动脉 支架术 

分 类 号：R654.205[医药卫生—外科学]