经桡动脉与经股动脉介入治疗急性心肌梗死的对比研究.docVIP

经桡动脉与经股动脉介入治疗急性心肌梗死的对比研究 　　作者：项　军，王　岩，王　磊，何凌宇，李　锐 作者单位：解放军九七医院心血管内科，江苏 徐州　221004 　　【摘要】 目的：探讨对急性心肌梗死患者经桡动脉途径行急诊介入治疗的有效性和可行性。方法：回顾性分析急诊介入治疗ST段抬高心肌梗死62例，对比经桡动脉介入(TRI,38例)及经股动脉介入(TFI,24例)穿刺成功率及经皮冠状动脉介入治疗(PCI)成功率、血管穿刺时间及手术时间、出血及穿刺相关并发症。结果：血管穿刺成功率：TRI组为97.4%，TFI组为100%，PCI成功率分别为94.7%和95.8%(P0.05)，均无明显差异。两组血管穿刺时间无显著差异(P0.05)。TRI组总PCI时间明显短于TFI组[(38.56±11.55) min 比(43.77±10.62) min，P0.05];穿刺相关并发症发生率明显低于TFI组(5.26%比16.67%，P0.01)。结论：经桡动脉途径急诊介入治疗急性心肌梗死安全有效，不逊于经股动脉途径，对于选择性手术可以优先选用。 　　【关键词】 心肌梗塞,经皮冠状动脉介入术,桡动脉;股动脉 　　Abstract：Objective： To evaluate efficacy and feasibility of emergency percutaneous coronary intervention (PCI) via radial artery path in patients with acute myocardial infarction (AMI). Methods：Clinical data of 62 patients with ST segment elevation myocardial infarction undergoing emergency PCI were retrospectively analyzed. There were 38(61.3%) cases in transradial intervention (TRI)group and 24(38.7%) cases in transfemoral intervention (TFI)group. Success rates，duration of operation and complications etc. were compared between TRI group and TFI group. Results：Success rate of vascular puncture in TRI group was 97.4%，in TFI group was 100%;success rate of PCI was 94.7%,95.8% respectively，all no significant difference between the two groups (P0.05 all). Duration of vascular puncture was no significant difference between the two groups (P0.05)，but PCI duration was significantly shorter in TRI group[(38.56±11.55) min vs.(43.77±10.62) min，P0.05]than that of TFI group. Incidence rate of relative complications of puncture in TRI group was significantly lower than that of TFI group (5.26% vs. 16.67%，P0.01). Conclusion： Emergency percutaneous coronary intervention via radial artery path is effective and safe in treatment of acute myocardial infarction，it′s not worse than transfemoral intervention，may be prefer in elective operation. 　　Key words：Myocardial infarction;Angioplasty，transluminal，percutaneous coronary;Radial artery;Femoral artery 　　迅速恢复心肌有效的血液灌注是救