肱动脉路径冠脉介入安全性评价

Safety Evaluation of Coronary Artery Intervention for Radial Artery Pathway

目的分析肱动脉路径冠脉介入的安全性。方法回顾该院在2017年6月—2018年12月期间收治的88例冠心病患者的病历资料,所有患者均在该院行冠脉介入术,依据穿刺路径差异将患者分成两组,一组经肱动脉路径穿刺,为研究组,一组经桡动脉路径穿刺,为对照组,比较两组患者的手术效果。结果两组患者均成功完成手术,手术成功率100.00%,差异无统计学意义(P>0.05);研究组患者首次穿刺成功率高于对照组,差异有统计学意义(χ^2=10.025,P<0.05);研究组患者并发症发生率高于对照组(χ^2=5.436,P<0.05);研究组患者治疗后HR为(85.42±7.88)次/min,LVEF为(62.07±7.37)%,SBP为(126.36±6.04)mmHg,hs-CPR为(7.24±3.22)mg/L,各项数据与对照组比较差异无统计学意义(P>0.05);研究组患者术后心功能I级占比45.45%(20例),II级占比45.45%(20例),III级占比9.09%(4例),各项数据与对照组比较差异无统计学意义(P>0.05)。结论经肱动脉路径行冠脉介入治疗效果明显,首次穿刺成功率高,但并发症较多,安全性有待商榷,临床应用中建议依据患者个体差异选择适合的穿刺路径。

Objective To analyze the safety of coronary intervention in the radial artery.Methods We reviewed the medical records of 88 patients with coronary heart disease admitted to the hospital from June 2017 to December 2018.All patients underwent coronary intervention in our hospital.The patients were divided into two groups based on the difference in puncture path.The group was puncture through the radial artery as the study group,one group was puncture through the radial artery as the control group.The surgical results of the two groups were compared.Results The operation was successful in both groups.The success rate was 100.00%,and there was no statistically significant difference(P>0.05).The success rate of the first puncture in the study group was higher than that in the control group,the difference was statistically significant(χ^2=10.025,P<0.05).The incidence of complications in the study group was higher than that in the control group,the difference was statistically significant(χ^2=5.436,P<0.05).The HR of the study group was(85.42±7.88)times/min after treatment,and the LVEF was(62.07±7.37)%,SBP of(126.36±6.04)mmHg,hs-CPR was(7.24±3.22)mg/L,and the data were not statistically significant compared with the control group(P>0.05);study group of postoperative cardiac function grade I accounted for 45.45%(20 cases),the grade II accounted for 45.45%(20 cases),and the grade III accounted for 9.09%(4 cases).The data were not statistically significant compared with the control group(P>0.05).Conclusion Transcatheter approach through the radial artery is effective,the first puncture success rate is high,but the complications are more,the safety is still to be discussed.In clinical application,it is recommended to select the appropriate puncture path according to individual differences.