不同穿刺途径行冠状动脉介入临床研究.docVIP

不同穿刺途径行冠状动脉介入的临床研究 　　[摘要] 目的 探讨不同穿刺途径行冠状动脉介入的可行性和安全性。 方法 入选我院心血管介入中心2014年1月～2015年2月患者91例，将其随机分为三组：其中经肱动脉途径设为 A 组（28例），经桡动脉途径设为 B 组（31例），经股动脉途径设为 C 组（32例），比较不同穿刺途径的平均穿刺操作时间、动脉血管痉挛、穿刺成功率及其他并发症发生率情况。 结果 三组手术成功率比较，A组较B组明显提高，差异有统计学意义（92.9% vs 87.1%，P0.05），A组的平均动脉穿刺时间较B组明显缩短，差异有统计学意义[（2.5±0.6）min vs （4.5±1.4）min，P0.05）]，但在相关的并发症方面，B组血管痉挛较A组增多，差异有统计学意义（19.4% vs 7.1%，P0.05），但在皮下淤血方面较A组明显减少，差异有统计学意义（3.6% vs 50.0%，P0.05），在皮下血肿较A组明显减少，差异有统计学意义（3.2% vs 17.9%，P0.05）。 结论 经桡动脉穿刺行冠状动脉介入是一种安全性较高，血管并发症少的检查方法， 股动脉穿刺途径可替补，肱动脉穿刺途径并发症多，不可在临床推广应用。 　　[关键词] 穿刺途径；冠状动脉介入；可行性；安全性 　　[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2015）29-0070-03 　　Clinical application of alternative approaches to the coronary intervention in management of coronary artery disease 　　TANG Changchun CHEN Ran GUAN Xiansong LIU Zhaoyun ZHAO Yangcheng JIA Ying 　　Department of Cardiology， the Central Hospital of Changsha City， Changsha 410006， China 　　[Abstract] Objective To explore the feasibility and safety of this clinical application of the coronary intervention by brachial artery path in management of coronary artery disease. Methods There were 91 cases performed percutaneous coronary intervention， they were divided into three groups randomly： （1）group A （by brachial artery path，28 cases）； （2） group B（by radial artery path，31 cases）； （3） group C（by radial artery path，32 cases），and complications of puncture were compared between three groups. Results The successful rate of puncture in group A increased compared with group B（92.9% vs 87.1%，P0.05）， while the average time of puncture markedly decreased [（2.5±0.6）min vs （4.5±1.4）min，P0.05）]. but in other complications， the spasm of artery in group B was significantly increased than A（19.4% vs 7.1%，P0.05）， but subcutaneous passive congestion（3.6% vs 50.0%，P0.05） and subcutaneous hemorrhage（3.2% vs 17.9%，P0.05） in group B significantly decreased compared with those of group A. Conclusion There was so unfeasibility and unsafety for this clinical application of coronary