文章摘要
张慧 蒋文彬 崔美平 董玉梅 蔡尚郎.经桡动脉和股动脉途径PCI治疗高龄冠心病患者的临床效果分析[J].,2015,15(10):1916-1918
经桡动脉和股动脉途径PCI治疗高龄冠心病患者的临床效果分析
Analysis on the Clinical Effects of Transradial and Femoral Approaches for Percutaneous Coronary Interventions Treatment on Elderly Patients withCoronary Heart Disease
  
DOI:
中文关键词: 高龄冠心病  桡动脉  股动脉  经皮冠状动脉介入
英文关键词: Elderly coronary heart disease  Radial artery  Femoral artery  Percutaneous coronary intervention
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作者单位
张慧 蒋文彬 崔美平 董玉梅 蔡尚郎 青岛大学医学院青岛阜外医院 
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中文摘要:
      目的:评价经桡动脉和股动脉途径PCI 治疗高龄冠心病患者近期和远期临床效果。方法:选取2007 年1 月至2012 年2 月 在我院行PCI治疗且年龄≥ 80 岁的冠心病患者237 例,按照患者入院PCI治疗途径分为经桡动脉途径组(Ⅰ组,n=114)和经股动 脉途径组(Ⅱ组,n=123)。记录和比较两组患者的手术效果、术后卧床时间和住院时间、术后并发症和主要不良心血管事件的发生 情况。结果:两组患者置入支架数、支架直径、支架长度、手术时间、对比剂用量、对比剂肾病和手术成功率比较差异均无统计学意 义(P>0.05)。Ⅰ组11.4%患者PCI过程中需更改介入路径,发生率显著高于Ⅱ组(P<0.05);Ⅰ组患者术后卧床时间和住院时间分别 为(4.8± 1.4)h 和(1.7± 1.1)d,均显著短于Ⅱ组患者(P<0.05);Ⅰ组患者血管并发症、围术期TIMI 小出血和围术期TIMI 大出血的发 生率均明显低于Ⅱ组患者(P<0.05);随访12 个月和24 个月时,两组患者主要不良心血管事件的发生率比较差异均无统计学意义 (P>0.05)。结论:经桡动脉途径行PCI治疗高龄(≥ 80 岁)冠心病患者具有时间短、出血等并发症少的优势,近期效果优于股动脉径 路,但远期临床效果与股动脉径路相当。
英文摘要:
      Objective:To investigate the short-term and long-term clinical effect of transradial and femoral approaches for percutaneous coronary interventions treatment on elderly patients with coronary heart disease.Methods:237 cases of patients with coronary heart disease who were aged≥ 80 years for PCI treatment were selected fromJanuary 2007 to February 2012. All the cases were divided into transradial group (group Ⅰ, n=114) and femoral group(Ⅱ group, n=123). The surgical results, postoperative bedridden time and hospital stay, incidence of postoperative complications and major adverse cardiovascular events were recorded and compared between the two groups.Results:No significant difference was observed in the numbers of stent placement, stent diameters, stent lengths, operation times, the amount of contrast agents, contrast-induced nephropathies and surgical success rate between the two groups(P>0.05). 11.4%of patients in group Ⅰ needed to change the involved path in the PCI process, the rate was much higher than that of groupⅡ(P<0. 05). The bedridden time and hospital stay of group Ⅰ were respectively (4.8± 1.4) h and (1.7± 1.1) d, which were obviously shorter than those of groupⅡ (P<0.05). The incidence rates of vascular complications, perioperative TIMI minor bleeding and perioperative TIMI major bleeding of group Ⅰ were all significantly lower than those of groupⅡ (P<0.05). Followed up for 12 months and 24 months, no significant difference was found in the incidence rates of major adverse cardiovascular events between the two groups (P>0.05).Conclusion:Transradial PCI had the advantages of shorter hospital stay and lower incidence of bleeding and other complications in the treatment of elderly (≥ 80 years) patients with coronary heart disease. Its short-term efficacy was better than that of femoral PCI, but the long-termefficacy was equal to that of femoral PCI.
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