高龄患者经桡动脉和股动脉行冠状动脉造影和支架植入术的效果分析

Comparison of Transradial and Transfemoral Approaches for Coronary Angiography and Coronary Stent Implantation in Elder Patients.

目的对比高龄患者中经桡动脉和股动脉途径行冠状动脉造影和支架植入术的安全性、可行性及疗效。方法216例接受介入诊疗的75岁以上冠心病心绞痛病人,随机分为桡动脉组及股动脉组,各108例。比较两组在冠脉造影及支架植入术中的动脉穿刺及手术操作时间、X线曝光时间、造影剂用量、支架植入数量、支架植入成功率、外周血管并发症发生率,以及支架植入术中两组特殊导管使用率,双钢丝及PTCA球囊使用率等的差异。结果桡动脉组及股动脉组的血管穿刺时间、穿刺成功率、造影成功率、支架成功率均无显著差异(P>0.05),术后不适反应发生率桡动脉组显著低于股动脉组;单个支架操作时间、特殊导管使用率、双钢丝及PTCA球囊使用率,桡动脉组均较股动脉组高,差异具有显著性(P<0.01),局部血管并发症率及术后患者舒适度、缩短住院时间,桡动脉组明显优于股动脉组,差异具有显著性(P<0.01)。结论高龄患者经桡动脉与股动脉途径介入诊疗具同样的安全性,可行性及疗效。

Objective To compare the clinical application of transradial and transfemoral approaches for coronary angiography and coronary stentt implantation in elder patients. Methods 216 elder patients（moro than 75 years） were randomly divided into radial artery group （n= 108） and femoral artery group （n= 108）. The success rate of arterial puncture, the rate of complications, the time of operation, X-ray exposure time, operation time of implanting stent, success rate of stent implantation and the vessel complications between two groups were compared. Results There were no remarkable differences in the time of arterial pu/acture, the success rate of artery puncture, success rate of coronary angiography and stent implantation between two groups（ P 〉 0.05）. After operation, the pe- ripheric vessel complications and discomfort were significantly lower in radial artery group, while X-my exposure time, the average operation time for implanting single stent, the usage rate of special catheter, double steel-wire and PTCA sacculus were significantly higher in radial artery group than those in femoral artery group （P 〈 0.01）. Conclusions In elder patients, compared with femoral artery approach, the radial artery approach for coronary angiography and coronary stent implantation appears equal safety, feasibility and efficacy.