不同手术入路PCI治疗STEMI患者与CCU入住时间对疗效的影响  

Effect of different operative approaches on the curative effect in patients with STEMI treated with PCI and stay time in CCU

作　　者：曾娟[1] 刘婷[1] 张娟[1] 王雅莉[1] ZENG Juan;LIU Ting;ZHANG Juan;WANG Yali(Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院心脏内科CCU,四川成都610041

出　　处：《西部医学》2018年第10期1471-1474,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(1203465)

摘　　要：目的分析不同手术入路对经皮冠脉介入术(PCI)治疗ST段抬高型心肌梗死(STEMI)患者的疗效与入住重症监护室(CCU)时间的影响。方法收集2015年1月～2016年5月我院收治的接受急诊PCI治疗的STEMI患者110例,其中经桡动脉介入穿刺60例(TRI组),经股动脉介入穿刺50例(TFI组),收集两组患者临床资料,比较治疗效果,统计穿刺成功率、PCI成功率、穿刺时间、X线暴露时间、球囊扩张时间、造影导管数、造影剂使用量、手术时间、穿刺点压迫时间、CCU入住时间、总住院时间,记录两组患者手术并发症及随访不良事件发生率及复发率。结果两组穿刺成功率、PCI成功率比较差异无统计学意义(P>0.05);TRI组造影导管数少于TFI组(P<0.05);穿刺点压迫时间、术后卧床时间、CCU入住时间及总住院时间均短于TFI组(P<0.05);TRI组迷走神经反射、尿潴留发生率均低于TFI组(P<0.05),但随访不良事件发生率及复发率比较差异无统计学意义(P>0.05)。结论 TRI、TFI下急诊PCI治疗STEMI疗效均肯定,但TRI可缩短患者卧床时间、CCU入住时间及住院时间,减少手术并发症。Objective To analyze the effect of different operative approaches on the curative effect in patients with ST segment elevation myocardial infarction（STEMI）treated with percutaneous coronary intervention（PCI）and the stay time in coronary care unit（CCU）.Methods 110 patients with STEMI treated by emergency PCI in the hospital from January 2015 to May 2016 were enrolled in the study,including 60 patients treated with transradial interventional puncture（TRI group）and 50 patients treated with ransfemoral interventional puncture（TFI group）.The clinical data of two groups were collected,and the curative effect was compared.The success rate of puncture,the success rate of PCI,puncture time,X-ray exposure time,balloon dilatation time,the number of angiographic catheters,the dosage of contrast agents,operation time,puncture point compression time,stay time in CCU and total hospitalization time were statistically analyzed.The incidence of complications and adverse events during follow-up were recorded.Results There was no significant difference between the two groups in the success rate of puncture and the success rate of PCI（P〉0.05）.The number of angiographic catheters in TRI group was smaller than that in TFI group,the puncture point compression time,postoperative time in bed,stay time in CCU and total hospitalization time were shorter than those of TFI group（P〈0.05）.The incidence of vagus reflex and urinary retention in TRI group was lower than that in TFI group（P〈0.05）,but there was no significant difference in the incidence of adverse events and recurrence rate during follow-up（P〉0.05）.Conclusion The curative effect of emergency PCI on STEMI under TRI and TFI is definite,but TRI can shorten the time in bed,the stay time in CCU and the hospitalization time,and reduce the complications of operation.

关 键 词：不同手术路径 经皮冠脉介入术 ST段抬高型心肌梗死 CCU入住时间 

分 类 号：R815[医药卫生—放射医学] R542.22[医药卫生—临床医学]