【摘要】 目的比较桡动脉和股动脉途径在老年冠心病患者介入手术的优缺点。方法选取我院心内科介入治疗的70岁以上老年冠心病患者72例,其中经桡动脉途径(桡动脉组)40例;经股动脉途径(股动脉组)32例;观察2组患者经皮冠状动脉球囊扩张成形加支架置入术的手术成功率及不良反应。结果与股动脉组相比,桡动脉组的穿刺成功时间[(5.3±1.2)min与(2.1±0.8)min,P<0.01]及手术时间[(112.0±6.1)min与(87.2±3.0)min,P<0.01]均比股动脉组长,而在手术成功率方面,两者差异无显著性(92.5%与93.8%,P>0.05)。2组在动静脉瘘、血管夹层及迷走神经反射方面没有差异(P均>0.05),与股动脉组相比,桡动脉组具有血肿发生率低(1/40与20/32,P<0.01)、加压包扎时间短[(5.0±2.5)min与(35.1±10.6)min,P<0.01]、住院时间短[(3.1±1.5d)与(5.7±1.8)d,P<0.05]的优点。结论经桡动脉途径具有并发症少、止血方便,无需卧床休息等优点,可以成为老年冠心病患者介入手术的常规途径。更多还原

【Abstract】 Objective To campare the condition of the transradial approach and the transfemoral approach using for percutaneous coronary intervention (PCI) in the elder patients with coronary heart disease.Methods 72 (more than 70 years old ) patients candidate for PCI were divided into the transradial group (n=40) and the transfemoral group including (n=32).The success rate and side effect of PTCA plus stenting were compared in the two groups.Results As compared to transfemoral group,transradial group had a long successful puncturing time and operation time[(5.3±1.2)min VS (2.1±0.8)min,P<0.01; (112.0±6.1)min VS (87.2±3.0)min,P<0.01,respectively].However,there was no significant difference in the success rate between the two groups(92.5% vs.93.8% P>0.05).There was no significant difference in the arterial-venous fistula、vascular dissection and the vagal reaction(P>0.05 for each).And compared to transfemoral approach,transradial group had a lower incidence of hematoma(1/40 VS 20/32,P<0.01) and a shorter time for enswathement with pressure and for hospitalization[ (5.0±2.5)min VS (3 5.1±10.6)min,P<0.01; (3.1±1.5)day VS (5.7±1.8)day,P<0.05,respectively].Conclusion In transfemoral approach,PCI has less complications and is easy to stop bleeding and does not need to stay in bed,which could become the routine approach for PCI,especially for elder patients.更多还原