经左侧桡动脉途径行急性心肌梗死急诊介入治疗的效果

Effect of emergency percutaneous coronary intervention for acute myocardial infarction by left radial artery approach

目的探讨经左侧桡动脉途径行急诊PCI的可行性。方法 114例ST段抬高型急性心肌梗死患者随机分为右侧桡动脉途径治疗组(n=54)和左侧桡动脉途径治疗组(n=60)。比较2组穿刺时间、造影导丝选择倾向、导管一次到位成功率及时间、造影剂用量、接触总放射线剂量、介入治疗成功率及并发症。结果 2组穿刺时间、左冠造影导管到位时间及一次到位成功率无显著差异,但左、右侧桡动脉造影导丝选择有显著差异。左侧桡动脉途径行右冠造影时造影导管到位时间及一次到位成功率高于右侧桡动脉组。2组介入治疗全过程中造影剂总量、介入治疗成功率、并发症无显著差异,而接触放射线总量左侧桡动脉途径较右侧桡动脉途径少。结论经左侧桡动脉途径行急诊PCI治疗是安全有效的。

Objective The explore the feasibility of the left radial approach in treatment of patients with acute myocardial infarction by pcrcutaneous coronary intervention. Methods A total of 114 patients with acute myocardial infarction were divided into right radial approach （right side group, n = 54） and left radial approach （left side group, n = 60）. The time of puncture, catheter in place of coronary artery originating, catheter success rate of first operation, the choice difference of guide wire, contrast agent dose, radioactive ray＇s volume, the success rate and complications of intervention therapy were compared between two groups. Results There were no significant differences in the time of puncture, contrast agent dose, the success rate and complications of intervention therapy between two groups, but there was no significant difference in the choice of guide wire between two groups. The contrast catheter time and success rate of catheter placement in the left radial artery group were higher than the right radial artery group. There were no significant differences in the total amount of contrast agent, the success rate of interventional treatment and complications between the two groups, but the total amount of radiation exposure in the left radial artery group was less than the right radial artery group. Conclusion The left radial approach is a safe and effective way in treatment of patients with acute myocardial infarction underwent percutaneous coronary intervention.