经皮桡动脉穿刺介入术治疗老年冠心病临床研究  

Clinical Study of Percutaneous Radial Artery Puncture in the Treatment of Elderly Coronary Heart Disease

作　　者：易金星 林文敏 YI Jinxing;LIN Wenmin(Department of Cardiovascular Medicine,the Hospital of Zhangping City,Zhangping Fujian 364400,China)

机构地区：[1]漳平市医院心血管内科,福建漳平364400

出　　处：《中国卫生标准管理》2024年第24期124-127,共4页China Health Standard Management

摘　　要：目的探讨不同经皮桡动脉穿刺介入术的临床效果,以期为老年冠心病介入术的后期标准制订提供了借鉴内容。方法将2020年1月—2022年12月在漳平市医院接受经皮桡动脉穿刺介入术治疗的60例老年冠心病患者纳入临床研究,基于随机数字法分为研究组和对照组,各30例,均行穿刺介入术,分别以经皮远端桡动脉入路、经前臂桡动脉入路;对比分析2组患者相关手术指标、首次穿刺成功率、手术成功率,测定术前及术后4周心功能指标,并观察与对比术中、术后的并发症发生率。结果研究组穿刺时间为(6.22±1.07)min,高于对照组的(5.25±1.12)min,研究组压迫止血时间为(6.17±0.71)h,低于对照组的(7.03±0.65)h,组间比较差异均有统计学意义(P<0.05),但组间造影剂用量、术后住院时间、首次穿刺成功率及手术成功率差异均无统计学意义(P>0.05)。术后,研究组左心室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic dimension,LVESD)分别(52.14±4.22)mm、(43.28±3.67)mm、(49.63±4.11)%,分别优于术前的(60.52±5.13)mm、(56.12±4.29)mm、(39.14±3.78)%,差异均存在统计学意义(P<0.05);对照组分别为(52.30±4.30)mm(、43.36±3.80)mm(、49.18±4.25)%,分别优于术前的(60.34±5.26)mm、(56.27±4.32)mm、(39.05±3.65)%,差异均有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。研究组患者术后并发症发生率为6.66%,低于对照组的33.33%,差异有统计学意义(P<0.05)。结论在老年冠心病介入术治疗中,采取经皮远端桡动脉入路介入虽比经前臂桡动脉穿刺时间略长,压迫止血时间短,且术后桡动脉闭塞少。Objective To analyze the safety and effectiveness of percutaneous radial artery puncture in the treatment of elderly coronary heart disease,and to provide clinical reference.Methods A total of 60 elderly patients with coronary heart disease who received percutaneous radial artery puncture interventional treatment in the Hospital of Zhangping City from January 2020 to December 2022 were included in the clinical study.Based on random number method,they were divided into study group and control group,with 30 cases in each group receiving percutaneous distal radial artery approach and transforearm radial artery approach respectively.Relevant surgical indexes of the two groups were compared,and the success rate of the first puncture and operation were compared,the cardiac function indexes were measured before and 4 weeks after surgery,and the incidence of complications during and after surgery were mastered.Results The puncture time of the study group was(6.22±1.07)min,higher than that of the control group(5.25±1.12)min.The compression hemostasis time of the study group was(6.17±0.71)h,lower than that of the control group(7.03±0.65)h,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the amount of contrast agent,postoperative hospital stay,first puncture success rate and operation success rate between groups(P>0.05).After surgery,the team left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic dimension(LVESD)were(52.14±4.22)mm,(43.28±3.67)mm,(49.63±4.11)%,respectively.It was better than(60.52±5.13)mm,(56.12±4.29)mm and(39.14±3.78)%before operation,respectively,and the differences were statistically significant(P<0.05).The control group was(52.30±4.30)mm,(43.36±3.80)mm and(49.18±4.25)%,respectively,which were better than the preoperative values of(60.34±5.26)mm,(56.27±4.32)mm and(39.05±3.65)%,and the differences were statistically significant(P<0.05).There was no signifi

关 键 词：经皮桡动脉穿刺介入术 经前臂桡动脉入路 冠心病 老年患者 安全性 有效性 

分 类 号：R541[医药卫生—心血管疾病]