经桡动脉应用一根指引导管完成直接经皮冠脉介入治疗的研究

The study of primary percutaneous coronary intervention with a single guiding catheter through radial artery

目的探讨在经桡动脉直接经皮冠脉介入治疗术中,应用一根指引导管(IL3.5)的安全性和可行性。方法选取2017年1月至2019年5月本院收治的急性心肌梗死行直接冠脉介入治疗的患者592例,根据治疗方式不同分为A组(n=314)和B组(n=278)。A组经桡动脉应用Tiger造影导管完成直接冠脉造影后行冠脉介入治疗,B组经桡动脉应用IL3.5完成直接冠脉介入治疗。比较两组患者桡动脉痉挛情况、更换导管情况、首次医疗接触至球囊扩张时间(FMC-to-B)、就诊至球囊扩张时间(D2B)、进入导管室至球囊扩张时间(C2B)、总操作时间。结果B组患者桡动脉痉挛发生率低于A组(P<0.05)。B组使用总导管数少于A组,差异有统计学意义(P<0.05)。B组D2B、C2B、鞘管置入时间、透视时间和总操作时间均短于A组(P<0.05)。结论经桡动脉应用IL直接冠脉介入治疗效果显著,可明显减少D2B、C2B、透视时间和手术操作时间,值得临床推广运用。

Objective To investigate the safety and feasibility of using a guide catheter(IL3.5)in direct percutaneous coronary intervention through radial artery.Methods 592 patients with acute myocardial infarction admitted to our hospital from January 2017 to May 2019 who received direct coronary intervention were divided into group A(n=314)and group B(n=278)according to different treatment methods.Group A received coronary intervention after direct coronary angiography through radial artery with Tiger catheter.Group B underwent direct coronary intervention through radial artery with IL3.5.The conditions of radial artery spasm,catheter replacement,the time from first medical contact to balloon dilation(FMC-to-B),the time from visit to balloon dilation(D2B),the time from entering the catheter room to balloon dilation(C2B),and the total operation time were compared between the two groups.Results The incidence of radial artery spasm in group B was lower than that in group A(P<0.05).The total number of catheters used in group B was less than that in group A,the difference was statistically significant(P<0.05).D2B,C2B,intrathecal catheter placement time,fluoroscopy time and total operation time in group B were shorter than those in group A(P<0.05).Conclusion Direct coronary interventional therapy with IL through radial artery can significantly reduce D2B,C2B,fluoroscopy time and operation time,which is worthy of clinical application.