经不同途径介入治疗冠状动脉粥样硬化性心脏病的对比研究  

Study on Comparison of Interventional Therapies through Different Pathways in Treatment of CHD

作　　者：毛婉 屈朝法[1] 

机构地区：[1]安徽省阜阳市人民医院心血管内科,安徽阜阳236006

出　　处：《实用临床医药杂志》2015年第17期74-76,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨经不同途径介入治疗冠状动脉粥样硬化性心脏病(冠心病)的疗效及安全性。方法 116例行经皮冠状动脉介入术(PCI)治疗的冠心病患者随机分为桡动脉组(经桡动脉介入治疗)59例及股动脉组(经股动脉介入治疗)57例,观察2组手术成功率、围术期情况,记录术后并发症,住院期间及随访期间的主要不良心血管事件(MACE)。结果桡动脉组6例(10.17%,6/59)更改介入途径,股动脉组更改介入途径者为0。2组手术成功率比较,差异无统计学意义(P>0.05);桡动脉组穿刺时间显著长于股动脉组(P<0.01);桡动脉组血管并发症和围术期小出血发生率高于股动脉组(P<0.05),2组MACE发生率差异无统计学意义(P>0.05)。结论与经股动脉介入途径相比,经桡动脉穿刺行PCI治疗冠心病所需穿刺时间较长,更改介入途径可能性较大,但疗效相似,且血管并发症及围术期出血发生率较低。Objective To explore the efficacy and safety of interventional therapies through different pathways in the treatment of coronary atherosclerosis disease （CHD）. Methods A total of 116 CHD patients treated with percutaneous coronary intervention （PCI） were randomly divided into radial artery group treated with PCI through radial artery （59 cases） and femoral artery group with PCI via femoral artery （57 eases）. In both groups, the successful rates of surgery and peri- operative conditions were observed and postoperative complications and major adverse cardiovascular events （MACE） during hospitalization and follow up were recorded. Results The interventional pathway was changed in 6 patients （10.17%, 6/59） in radial artery group and in 0 patient in femoral artery group. There was no significant difference between two groups in successful rate of surgery （P〉0.05）. Radial artery group was evidently longer in puncture time （P〈0.01）, but markedly lower in the rates of vascular complications and peri- operative minor bleeding than femoral artery group （ P 〈 0.05）. However, the difference in MACE rate was not significant between two groups （P 〉 0.05）. Conclusion Compared with interventional therapy through femoral artery, PCI through radial artery requires longer surgical duration and has higher rate in changing interventional pathway, but with similar clinical efficacy and lower rates of vascular complications and peri- operative bleeding.

关 键 词：冠状动脉粥样硬化性心脏病 经皮冠状动脉介入术 桡动脉 股动脉 并发症 

分 类 号：R541.4[医药卫生—心血管疾病]