门诊冠状动脉造影一日出院的可行性与安全性研究

The feasibility and safety of same-day discharge after coronary angiography

目的评价经前臂动脉途径门诊开展冠状动脉造影一日出院的可行性与安全性。方法采用前瞻性对照试验方法,患者连续入组。选取本院门诊就诊患者100例作为试验组,另选取同期住院接受冠状动脉造影检查患者100例作为对照组。观察比较两组患者造影成功率、不同直径造影导管使用率、术中不良事件(包括死亡,恶性心律失常,急性心肌梗死,冠状动脉痉挛、夹层、穿孔和闭塞)及术后不良事件(包括死亡,急性心肌梗死,患侧上肢血肿,假性动脉瘤,骨筋膜室综合征和桡动脉闭塞)的发生情况。结果两组患者的有效性和安全性比较均无显著差异,但冠状动脉造影一日出院显著减少了相关医疗费用。结论在病情平稳的患者中经前臂动脉途径进行冠状动脉造影一日出院安全、可行,同时能够显著减少医疗费用,缩短患者住院时间。

Objective To evaluate the feasibility and safety of same-day discharge after coronary angiography. Method A total of 100 outpatients who received coronary angiography in our hospital were consecutively selected, and 100 inpatients were selecteded as control group. Primary endpoints included success rate, use ratio of angiographic catheter with different diameters, adverse events during the procedure （such as death, malignant arrhythmia, acute myocardial infarction, coronary artery spasm, coronary artery dissection, perforation or occlusion） and after the procedure （such as death, acute myocardial infarction, upper limb haematoma, osteofascial compartment syndrome, radial artery pseudoaneurysm or occlusion）. Result Between the two groups, there were no signiifcant differences whether in safety or feasibility endpoints. While, the medical expenditure of outpatients was lower than inpatients. Conclusion Same-day discharge after coronary angiography in patients with steady condition is safe and feasible, and it could decrease the medical expenditure and shorten the admission time.