急诊经桡动脉与股动脉入路介入治疗ST段抬高急性心肌梗死对比研究

To compare primary percutaneous coronary intervention via transradial with transfemoral approach on the treatment of acute ST segment elevation myocardial infarction

目的观察经桡动脉入路行急诊ST段抬高急性心肌梗死直接经皮冠状动脉介入(PCI)治疗的有效性和安全性。方法选择沈阳军区总医院2005年1月至2006年10月连续607例ST段抬高性急性心肌梗死(STEMI)住院患者,分别接受经桡动脉入路(273例)或经股动脉入路(334例)途径行PCI治疗,观察两组手术成功率和并发症发生率。结果两组患者PCI成功率差异无统计学意义(97.07%对95.81%,P>0.05)。经桡动脉入路组局部血肿、假性动脉瘤、迷走反射发生率显著低于经股动脉入路组。结论行PCI治疗的STEMI患者经桡动脉入路途径是安全、有效和可行的方法,与经股动脉比较,经桡动脉途径可减少并发症的发生。

Objective To observation safety and efficacy of the radial approach with the femoral approach for percutaneous coronary intervention （PCI） in patients with acute ST segment elevation myocardial infarction （STEMI）. Methods From Jan ,2005 to Oct ,2006 ,a total of 607 patients, PCI in 273 patients via radial artery and in 334 patients via femoral artery. Major complications and Procedure success rate in the two groups were recorded. Results The Success rate, 97.07% （265/273） in Group via radial artery and 95.81% （320/334） in Group via femoral artery was not signicantly difference （ P 〉 0. 05 ）. The rates of the local hematoma, pseudoaneurysm and aberration reflex in Group via radial artery were significantly lower than those in Group via femoral artery. Conclusion The transradial approach of PCI compared to traditional transfemoral approach in STEMI is safe and feasible, with relatively less vascular complications and more comfortable to the patients.