老年冠心病患者经桡动脉入路行冠状动脉介入治疗的疗效

Clinical efficacy of percutaneous coronary interventions by transradial access in old patients with coronary heart disease

目的:探讨老年冠心病患者经桡动脉入路行冠状动脉介入治疗(PCI)的可行性及安全性。方法:入选2012年1-9月在我院行冠脉介入治疗的患者126例,术前行Allen试验均阳性,随机均分入桡动脉入路组(63例)或股动脉入路组(63例)。详细记录手术穿刺成功率、穿刺时间、手术成功率、手术时间、住院时间、住院费用及血管并发症的发生及情况。结果:两组均成功手术,手术时间无差异,出现血管并发症11例(8.7%):桡动脉组2例(3.2%),股动脉组9例(14.3%),桡动脉组血管并发症发生率较股动脉组低(P<0.05)、住院时间短、费用少(均P<0.01),住院时间与住院费用正相关(P<0.01)。结论:老年冠心病患者经桡动脉入路行PCI较传统经股动脉入路血管并发症发生率低、住院时间短、费用少、预后好,广泛普及可行且安全。

Objective To explore the feasibility and safety of percutaneous coronary interventions （PCI） by transradial approach in old patients with coronary heart disease（CHD）. Methods One hundred and twenty six old patients with CHD treated with PCI were randomizely devided into racial access group （63 cases） and femoral access group （63 cases）, all patients＇ Allen＇s test were positive before PCL Success rates of puncture, time of puncture, success rates of PCI, time of PCI, hospitalization time, hospitalization costs and vascular complications were recorded. Results All PCI were accomplished successfully, time of PCI was no statistically significant different between two groups, hospitalization time and hospitalization costs were positively correlated （P 〈 0.01 ）, vascular complications occurred in 11 patients （8.7%）： the radial group （2 cases, 3.2%） and the femoral group （9 cases, 14.3% ）. Occurrence rate of vascular complications in racial access group was lower （P 〈 0.05）, hospitalization time was shorter and hospitalization costs were less （P 〈 0.01 ）, compared with femoral access group. Conclusions PCI by transradial approach in old patients with coronary heart disease is safe and valuable to be widely applied, with lowre occurrence rate of vascular complications, shorter hospitalization time, less cost and better prognostics.