80岁以上高龄冠心病患者经桡动脉行冠状动脉介入诊疗的可行性分析

Feasibility of Transradial Percutaneous Coronary Intervention in Coronary Artery Disease Patients Elder Than 80 Years of Age

目的：评价80岁以上高龄冠心病患者经桡动脉行冠状动脉（冠脉）造影和经皮冠脉介入治疗（PCI）的可行性。方法：纳入2013-12至2015-12在我院行冠脉介入诊疗的661例60岁以上的冠心病患者为研究对象,其中76例80岁以上的高龄老年患者作为观察组,年龄80～92岁,平均（83.2±3.8）岁;60岁以上的老年患者585例作为对照组,年龄60～79岁,平均（68.3±5.2）岁,对两组患者的临床特点、冠脉病变、穿刺桡动脉失败率、PCI成功率和术中、术后并发症等进行回顾性分析并作比较。结果：对照组和观察组患者在穿刺桡动脉失败改肱动脉途径分别为1.0%和2.6%、穿刺桡动脉失败改股动脉途径分别为1.5%和2.6%、PCI成功率分别为96.5%和96.4%、手术操作时间分别为（45.7±21.2）min和（47.6±18.5）min、单纯冠状动脉造影对比剂使用量分别为（28.9±10.2）ml和（30.6±8.8）ml、冠状动脉造影＋PCI对比剂使用量分别为（150.4±35.7）ml和（155.6±28.2）ml、术中相关心脏事件分别为0.7%和1.3%、术后血管并发症分别为0.9%和2.6%、术后住院天数分别为（5.7±1.9）d和（6.3±2.7）d等差异无统计学意义（P〉0.05）。结论：高龄老年冠心病患者经桡动脉行冠状动脉介入诊疗是安全可行的。

Objective：To review the feasibility of transradial percutaneous coronary intervention（PCI） in coronary artery disease（CAD） patients elder than 80 years of age.Methods：A total of 661 CAD patients elder than 60 years with PCI in our hospital from 2013-12 to 2015-12 were enrolled and divided into 2 groups：Observation group,the patients with the mean age of（83.2±3.8,80-92） years,n=76 and Control group,the patients with the mean age of（68.3±5.2,60-79） years,n=585.Clinical features,coronary lesions,radial puncture failure rate,PCI success rate and intra-,post-operative complications were retrospectively analyzed and compared between 2 groups.Results：In Control group and Observation group,the patients from failed radial artery puncture changing to brachial artery puncture were 1.0% and 2.6%,from failed radial artery puncture changing to femoral artery puncture were 1.5% and 2.6% respectively;PCI success rates were 96.5% and 96.4%,operational times were（45.7±21.2） min and（47.6±18.5） min,the contrast agent used in coronary angiography（CAG） were（28.9±10.2） ml and（30.6±8.8） ml and in CAG＋PCI were（150.4±35.7） ml and（155.6±28.2） ml,intra-operative cardiac events were 0.7% and 1.3%,post-operative vascular complications were 0.9% and 2.6%,post-operative hospital stay times were（5.7±1.9） days and（6.3±2.7） days respectively;the above differences had no statistic meaning.Conclusion：Transradial PCI is safe and feasible in elder CAD patients.