不同穿刺途径行冠状动脉介入的临床研究  

Clinical application of alternative approaches to the coronary intervention in management of coronary artery disease

作　　者：汤长春[1] 陈然[1] 关贤颂[1] 刘赵云[1] 赵杨程 贾颖[1] 

机构地区：[1]长沙市中心医院心内科,湖南长沙410006

出　　处：《中国现代医生》2015年第29期70-72,共3页China Modern Doctor

摘　　要：目的探讨不同穿刺途径行冠状动脉介入的可行性和安全性。方法入选我院心血管介入中心2014年1月~2015年2月患者91例,将其随机分为三组:其中经肱动脉途径设为A组(28例),经桡动脉途径设为B组(31例),经股动脉途径设为C组(32例),比较不同穿刺途径的平均穿刺操作时间、动脉血管痉挛、穿刺成功率及其他并发症发生率情况。结果三组手术成功率比较,A组较B组明显提高,差异有统计学意义(92.9%vs87.1%,P<0.05),A组的平均动脉穿刺时间较B组明显缩短,差异有统计学意义[(2.5±0.6)min vs(4.5±1.4)min,P<0.05)],但在相关的并发症方面,B组血管痉挛较A组增多,差异有统计学意义(19.4%vs 7.1%,P<0.05),但在皮下淤血方面较A组明显减少,差异有统计学意义(3.6%vs 50.0%,P<0.05),在皮下血肿较A组明显减少,差异有统计学意义(3.2%vs 17.9%,P<0.05)。结论经桡动脉穿刺行冠状动脉介入是一种安全性较高,血管并发症少的检查方法,股动脉穿刺途径可替补,肱动脉穿刺途径并发症多,不可在临床推广应用。Objective To explore the feasibility and safety of this clinical application of the coronary intervention by brachial artery path in management of coronary artery disease. Methods There were 91 cases performed percul^aneous coronary intervention, they were divided into three groups randomly： （1）group A （by brachial artery path, 28 cases）; （2） group B（by radial artery path,31 cases）; （3） group C（by radial artery path,32 cases）,and complications of punc- ture were compared between three groups. Results The successful rate of puncture in group A increased compared with group B（92.9% vs 87.1%,P〈0.05）, while the average time of puncture markedly decreased [（2.5±0.6）min vs （4.5± 1.4）min,P〈0.05）]. but in other complications, the spasm of artery in group B was significantly increased than A （19.4% vs 7.1%,P〈0.05）, but subcutaneous passive congestion （3.6% vs 50.0%,P〈0.05） and subcutaneous hemor rhage（3.2% vs 17.9%,P〈0.05） in group B significantly decreased compared with those of group A. Conclusion There was so unfeasibility and unsafety for this clinical application of coronary intervention by brachial artery path in man- agement of coronary artery disease, It may be no suitable puncturing position in clinical application of the coronary in- tervention.

关 键 词：穿刺途径 冠状动脉介入 可行性 安全性 

分 类 号：R541.4[医药卫生—心血管疾病]