经桡动脉及股动脉途径急诊介入治疗STEMI的对照研究

Control study on treatment of STEMI by emergency transradial or transfemoral percutaneous coronary intervention

目的探讨经桡动脉急诊经皮冠状动脉介入(PCI)治疗ST段抬高急性心肌梗死(STEMI)的临床疗效及可行性。方法STEMI行急诊PCI患者225例,随机分为桡动脉组123例,股动脉组102例。分析两组患者介入治疗的成功率、疗效、手术时间和术后并发症的发生率。结果两组患者在心肌梗死部位、血管病变位置、严重程度等方面,差异均无统计学意义。股动脉组PCI成功率为92.3%,桡动脉组为94.3%,两组之间无统计学差异(P>0.05)。桡动脉组术后并发症发生率(6.5%)明显低于股动脉组(16.7%,P<0.05)。结论经桡动脉途径行急诊PCI治疗STEMI与经股动脉途径PCI成功率相似,而术后并发症少,值得临床推广。

Objective To discuss the clinical effect and feasibility of emergency transradial percutaneous coronary intervention （PCI） in the treatment of ST-segment elevation myocardial infarction （STEMI）.Methods The patients with STEMI after PCI （n=225） were randomly divided into the transradial group （n=123） and transfemoral group （n=102）.The success rate,curative effect,operation time and incidence of post-operation complications were compared and analysed in two groups.Results There was no statistical difference in the comparison of degree and location of STEMI and vascular pathological changes between two groups.The success rate of PCI was 92.3% in the transfemoral group and 94.3% in the transradial group.There was not different statistically （P0.05） between two groups.The incidence of post-operation complications was lower significantly in the transradial group （6.5%） than that in the transfemoral group （16.7%,P0.05）.Conclusion The success rate of treatment of STEMI with emergency transradial PCI is similar to that with transfemoral PCI,and transradial PCI has less post-operation complications.It is worth popularizing in clinic.