经桡动脉和经股动脉途径行冠状动脉造影的临床对比分析

Clinical Comparison of Transradial Versus Transfemoral Approach for Coronary Angiography

目的比较经桡动脉和经股动脉行冠状动脉造影的优缺点。方法 2006年7月-2008年9月疑诊冠心病拟行冠状动脉造影术的患者287例,随机分成经桡动脉组(185例)和经股动脉组(102例),对比观察其穿刺成功率、手术操作时间、X线曝光时间、止血包扎时间、肢体制动时间、术后住院天数和并发症的发生率。结果桡动脉组的平均X线曝光时间、穿刺成功率分别为(5.13±3.72)min和98.92%,经股动脉组为(4.78±3.51)min和100%,两组比较差异无统计学意义(P>0.05);手术操作时间分别为(19.62±3.58)min和(16.57±4.30)min,两组比较差异有统计学意义(P<0.05);经桡动脉组止血包扎时间和肢体制动时间分别为(0.72±1.15)min和4～6h,经股动脉组为(20±7.32)min和20～24h,两组比较差异有统计学意义(P<0.05);经桡动脉组的术后住院天数为(3.06±1.42)d,少于经股动脉组(4.97±3.07)d(P<0.01);两组局部血肿发生率分别为0和1.96%,差异有统计学意义(P<0.05);经桡动脉组动脉痉挛发生率为2.16%,经股动脉组无动脉痉挛发生,两组比较差异有统计学意义(P<0.05)。结论经桡动脉径路行冠状动脉造影是安全有效的方法 ,具有止血容易、不需卧床、痛苦小、并发症少和住院时间短的优点,患者更易接受。

Objective To compare the advantages and disadvantages of coronary angiography via radial or femoral artery. Methods Two hundred and eightyseven cases of suspected coronary artery disease were randomly divided into transradial approach group （n= 185） and transfemoral approach group （n= 102） by the artery approaches from July 2006 to September 2008 in Qianan People＇s Hospital. The success rate, operating time, X- ray irradiation time, hemostasis and packing time, limbs＇ braking time, hospitalized day after operation, and the incidence rate of complications were observed and compared between the two groups. Results X - ray irradiation time and the success rate in transradial approach group were similar to these in transfemoral approach group [ （5.13 ± 3.72） min vs. （4.78 ± 3.51） min, 98.92% vs. 100%, P 〉 0.05]. Hernostasis and packing time and the limbs＇ braking time in transradial approach group were significantly lower than those in transfemoral approach group [ （0.72± 1.15） min vs. （20 ± 7.32） min, （4-6） hrs vs. （20-24） hrs, P〈0.05]. The hospitalized day after operation and the incidence rate of local hematorna in transradial approach group were significantly lower than those in transfemoral approach group [ （3.06 ± 1.42） d vs. （4.97 ±3.07） d, P 〈 0.01 ; 0 vs. 1.96 %, P 〈 0.05]. The operating time and the rate of artery spasm in transradial approach group were higher than those in transfemoral approach group [（19.62±3.58） minvs. （16.57±4.30） min, P〈0.05; 2.16% vs. 0, P〈0.05]. Conclusions Transradial approach for coronary artery angiography is a saf is and effective approach. The patient need not be confined to bed, with the advantages of rapid hemostasis, less pain, lower complications, shorter hospitalized time and easy acceptance.