经股动脉与经桡动脉入路经皮冠状动脉介入术治疗高龄冠心病患者的临床疗效比较

Comparative Study for Clinical Effect of PCI on Senile Coronary Heart Disease Between Transradial Approach and Transfemoral Approach

目的比较经股动脉与经桡动脉入路经皮冠状动脉介入术(PCI)治疗高龄冠心病患者的临床疗效。方法选取2014年榆林市第四(星元)医院收治的高龄冠心病患者78例(年龄≥80岁),采用信封法分为股动脉组和桡动脉组,每组39例。股动脉组患者采用经股动脉入路PCI治疗,桡动脉组患者采用经桡动脉入路PCI治疗。比较两组患者PCI成功率、X线暴露时间、手术时间、术后卧床时间、住院时间、近期和远期心脏事件发生情况及并发症发生情况。结果两组患者PCI成功率、X线暴露时间、手术时间比较,差异无统计学意义(P>0.05);桡动脉组患者术后卧床时间和住院时间均短于股动脉组(P<0.05)。股动脉组患者近期和远期心脏事件发生率分别为2.6%、71.8%,桡动脉组分别为7.7%、43.6%。两组患者近期心脏事件发生率比较,差异无统计学意义(P>0.05);桡动脉组患者远期心脏事件发生率低于股动脉组(P<0.05)。桡动脉组患者并发症发生率为7.8%,低于股动脉组的30.7%(P<0.05)。结论经桡动脉入路PCI较经股动脉入路PCI能有效缩短高龄冠心病患者术后卧床时间和住院时间,降低远期心脏事件发生率及并发症发生率。

Objective To compare the clinical effect of PCI on senile coronary heart disease between transradial approach and transfemoral approach. Methods A total of 78 senile patients（ equal or over 80 years old） with coronary heart disease were selected in the Fourth（ Xing Yuan） Hospital of Yulin in 2014,and they were divided into A group and B group according to envelope grouping method,each of 39 cases. Patients of A group received transfemoral approach PCI,while patients of B group received transradial approach PCI. Success rate of PCI,X- ray exposure time,duration of operation,postoperative bedridden time,hospital stays, incidence of short- term cardiac events, long- term cardiac events and complications were compared between the two groups. Results No statistically significant differences of success rate of PCI,X- ray exposure time or duration of operation was found between the two groups（ P〈0. 05）,while postoperative bedridden time and hospital stays of B group were statistically significantly shorter than those of A group（ P〈0. 05）. The incidence of short- term cardiac events,long- term cardiac events and complications of A group was 2. 6%,71. 8% and 30. 7%, respectively, that of B group was7. 7%,43. 6% and 7. 8%,respectively; no statistically significant differences of incidence of short- term cardiac events was found between the two groups（ P〈0. 05）, while incidence of long- term cardiac events and complications of B group was statistically significantly lower than that of A group, respectively（ P〈0. 05）. Conclusion Compared with transfemoral approach PCI, transradial approach PCI can effectively shorten the postoperative bedridden time and hospital stays of senile patients with coronary heart disease,reduce the incidence of long- term cardiac events and complications.