经桡动脉急诊PCI治疗急性冠脉综合征疗效观察.docVIP

经桡动脉急诊PCI治疗急性冠脉综合征疗效观察 　　作者：姜胜 王庸晋 王治平 李启富 秦丽霞 张晓霞 作者单位：长治医学院附属和平医院心内科 　　【摘要】 目的：探讨桡动脉途径急诊经皮冠状动脉介入(PCI)治疗急性冠脉综合征(ACS)的效果。方法：回顾性分析经桡动脉急诊PCI治疗21例ACS患者的临床资料，随访12个月明确预后。结果：本组ACS患者发病-就诊时间(4.1±2.6) h，就诊-球囊扩张时间(70±17) min，术中置入药物支架(1.3±0.6)枚，病变血管前向血流100%达TIMI3级。术中6例发生低血压，4例发生室颤/室速。随访12个月左室射血分数、左室舒张末径、左室收缩末径无明显改变，无主要不良心脏事件发生。结论：ACS患者经桡动脉行急诊PCI安全可行，效果肯定。 　　【关键词】 急性冠脉综合征;桡动脉;经皮冠状动脉介入;急诊 　　Efficacy of Transradial Approach for Emergency Percutaneous Coronary 　　Intervention (PCI) for Acute Coronary Syndrome 　　Jiang Sheng,Wang Yongjin,Wang Zhiping,et al. 　　Department of Cardiology, He Ping Hospital,Changzhi Medical College 　　Abstract Objective:To explore the outcome of transradial approach for emergency percutaneous coronary intervention(PCI)in patients with acute coronay syndrome.Methods:21 patients with acute coronary syndrome underwent treatment of transradial PCI whose clinical data were retrospectively analyzed and followed up for 12 months.Results:The time from onset of symptom to dignosis was (4.1±2.6)hours and the time Door to Balloon was (70±17) minutes in the patients with ACS.In interventional treatment the patients received(1.3±0.6) drug eluting stents and got TIMI3 grade flow in all criminal ateries.6 of the patients were complicated with hypotension and 4 cases suffered from ventricular fibrillation or ventricular tachycardia in PCI. At 12 month follow-up, LVEF, LVDd and LVDs were not difference and no major adverse cardiac events occurred compared with that of admission.Conclusion:Transradial approach for emergency percutaneous coronary intervention (PCI) in patients with acute coronay syndrome was safety and valid. 　　Key words Acute coronary syndrome;Radial;Percutaneous coronary intervention;Emergency 　　急性冠脉综合征(ACS)包括急性ST段抬高心肌梗死(STEMI)，急性非ST段抬高心肌梗死(NSTEMI)和不稳定型心绞痛(UA)，是心血管急诊医疗的主要原因。急诊PCI是治疗ACS的重要方法，经桡动脉途径行PCI具有创伤小、血管并发症少、不影响抗凝药物连续使用、患者易于接受等优点。本院心内科在熟练掌握经桡动脉途径PCI技术基础上，经桡动脉行急诊PCI治疗ACS患者，本文对结果进行分析明确其效果。 　　1 资料与方法 　　1.1 一般资料