| 李 鹏,胡 强,张 颖,王 娟,孙理华.不同动脉途径行经皮冠状动脉介入治疗高龄冠心病的临床疗效观察[J].,2019,19(7):1353-1356 |
| 不同动脉途径行经皮冠状动脉介入治疗高龄冠心病的临床疗效观察 |
| Observation on the Therapeutic Effect of Percutaneous Coronary Intervention on Coronary Artery Disease in Different Arteries |
| 投稿时间：2018-06-28 修订日期：2018-07-23 |
| DOI：10.13241/j.cnki.pmb.2019.07.035 |
| 中文关键词: 高龄冠心病 动脉途径 经皮冠状动脉介入治疗 心功能 心血管事件 并发症 |
| 英文关键词: Elderly coronary heart disease Arterial approach Percutaneous coronary intervention Cardiac function Cardiovascular events Complications |
| 基金项目:新疆维吾尔自治区自然科学基金项目(2016D01C244) |
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| 中文摘要: |
| 摘要 目的：探讨不同动脉途径行经皮冠状动脉介入治疗高龄冠心病的临床疗效和安全性。方法：选取2014年1月~2017年1月我院收治的265例高龄冠心病患者为研究对象，根据就诊顺序将受试者分为对照组132例及研究组133例，对照组患者给予股动脉途径(TFI)行经皮冠状动脉介入治疗，研究组患者给予桡动脉途径(TRI)行经皮冠状动脉介入治疗，比较两组患者的手术情况、手术前后各心功能指标变化、心血管不良事件及并发症的发生情况。结果：两组患者的手术成功率、支架数量、造影剂用量比较差异无统计学意义(P＞0.05)，但研究组患者动脉穿刺时间、导管插入时间及X线曝光时间均长于对照组，卧床时间及住院时间均明显短于对照组(P<0.05)。治疗后，两组患者的左心射血分数(LVEF)、左室收缩末期内径(LVESD)及左室舒张末期内径(LVEDD)较治疗前均明显改善，且研究组优于对照组(P＜0.05)，研究组患者心血管不良事件发生率及各并发症发生率均显著低于对照组(P＜0.05)。结论：TRI与TFI在经皮冠状动脉介入术治疗高龄冠心病患者的手术效果相当，但TRI在改善患者心功能、减少心血管不良事件的效果更好且安全性更高，可做为高龄冠心病患者PCI治疗的首选途径。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the clinical efficacy and safety of percutaneous coronary intervention in the treatment of elderly patients with coronary heart disease. Methods: 265 cases of elderly patients with coronary heart disease admitted in our hospital from January 2014 to January 2017 were selected as the subjects. According to the order of treatment, all patients were divided into the control group (132 cases) and the study group (133 cases). Patients in the control group underwent percutaneous coronary intervention with the femoral artery approach (TFI) and patients in the study group underwent percutaneous coronary intervention with the radial artery ap- proach (TRI). The operation, changes of cardiac function indexes before and after surgery, incidence of cardiovascular adverse events and complications were compared between the two groups. Results: There was no significant difference in the success rate of surgery, the number of stent, contrast agent dosage between the two groups (P>0.05). However, the time of arterial puncture, the insertion time of the catheter and the time of X-ray exposure in the study group were all longer than those in the control group, and the bed time and the time of hospitalization were significantly shorter than those in the control group (P<0.05). After treatment, the left ventricular ejection fraction (LVEF), the left ventricular end systolic diameter (LVESD) and the left ventricular end diastolic diameter(LVEDD) were significantly im- proved than those before the treatment, which were better in the study group than those of the control group (P<0.05), the incidence of adverse cardiovascular events and complications in the study group were significantly lower than those in the control group (P<0.05). Conclusion: TRI and TFI were quite effective in the treatment of elderly patients with coronary heart disease by percutaneous coronary intervention, and TRI was better and safer in improving cardiac function and reducing cardiovascular adverse events. It could be used as the first choice for the treatment of PCI in elderly patients with coronary heart disease. |
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