以单根JL3.5指引导管经桡动脉行急诊冠状动脉造影和经皮冠状动脉介入治疗的可行性研究  

A single JL 3.5 guiding catheter for transradial coronary angiography and intervention in patients with acute ST elevation myocardial infarction

作　　者：史东[1] 韩丽[1] 李玉亮[1] 段文涛[1] 张峰[1] 任自文[1] 

机构地区：[1]泰达国际心血管病医院心内科,天津300457

出　　处：《中国介入心脏病学杂志》2016年第8期448-451,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的评估急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中以单根JL 3.5指引导管经桡动脉行冠状动脉造影和PCI的可行性。方法选择泰达国际心血管病医院心内科2012年10月至2015年10月经桡动脉行急诊PCI的156例急性ST段抬高心肌梗死患者,分为试验组69例,初始选择JL 3.5指引导管行急诊冠状动脉造影及PCI;对照组87例,按常规方法行急诊冠状动脉造影及PCI。比较两组患者的一般资料、PCI情况以及术后30 d内的主要不良心血管事件(major adverse cardial events,MACE)发生情况。结果两组患者的一般资料、导管相关并发症、30d内MACE发生率的差异均无统计学意义(均P>0.05)。对照组桡动脉痉挛占比[10例(11.5%)比2例(2.9%),P=0.045]、进急诊室至球囊扩张(D2B)时间[(71.24±14.01)min比(66.59±13.98)min,P=0.041]、进导管室至球囊扩张(C2B)时间[(17.89±3.89)min比(15.20±3.47)min,P<0.001]、手术时间[(31.11±7.25)min比(27.98±6.78)min,P=0.007]、X线曝光时间[(10.18±2.34)min比(8.94±2.12)min,P=0.001]以及对比剂用量[(91.12±10.25)ml比(83.47±9.87)ml,P<0.001]均高于试验组,差异均有统计学意义。结论急诊PCI中以JL 3.5指引导管经桡动脉行冠状动脉造影和PCI安全有效,可以缩短D2B、C2B、手术及X线曝光时间,减少桡动脉痉挛及对比剂用量。Objective To evaluate the feasibility and safety of using a single guiding catheter （JL 3.5 ） for transradial coronary angiography and intervention in patients with ST elevation myocardial infarction （STEMI）. Methods From October 2012 to October 2015, 156 patients with STEMI were retrospectively enrolled. Patients performed emergent coronary angiograpiay （CAG） and primary pereutaneous coronary intervention （PCI） via a single JL 3.5 guiding catheter （treatment group, n = 69） or performed CAG via Tig catheter and primary PCI via guiding catheters （ control group, n = 87 ）. Clinical data, complications rates, procedure time and MACE in 30 days between the 2 groups were analyzed. Results The two groups had similar clinical data, complications and MACE in 30 days. There were significant reduction in radial artery spasm （11.5% vs. 2.9%, P=0.045）, door-to-balloon （D2B） time （71.24±14.01 miuvs. 66.59± 13.98 rain, P = 0. 041 ）, catheterization laboratory door to balloon （C2B） time （17.89 ± 6.78 rain vs. 15.2 ±3.47 min, P 〈0.001）, procedure time （31.11 ±7.25 min vs. 27.98±6.78 min, P=0.1307）, fluoroscopy time （ 10. 18 ±2. 34 rain vs. 8.94 ±2. 12 rain, P =0. 001 ） and contrast consumption （91.12 ± 10. 25 ml vs. 83.47 ±9.87 ml, P 〈 0. 001 ） in the treatment group. Conclusions A single guiding catheter （JL 3.5 ）for coronary angiography and intervention in patients with STEMI is feasible and safe. It can shorten C2B time, D2B time, procedure time, fluoroscopy time, reduce radial artery spasm and contrast consumption.

关 键 词：心肌梗死 冠状动脉造影 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]