经桡动脉与经股动脉途径对急诊PCI患者预后的影响

The influences of emergency PCI with transradial and transfemoral artery on patients with acute ST-segment elevation myocardial infarction

目的探讨不同手术途径急诊经皮冠状动脉介入治疗(PCI)对急性ST段抬高型心肌梗死患者预后的影响。方法回顾性分析确诊为急性ST段抬高型心肌梗死并行急诊PCI治疗的患者511例,桡动脉组403例、股动脉组108例,观察2组患者平均住院日、1周内超声心动图、术中及术后穿刺并发症及心脏不良事件发生情况。结果经桡动脉急诊PCI组的平均住院(9.87±4.71)d、术中室颤发生率2.23%、即刻血流TIMI 3级94.79%、射血分数正常率53.60%、局部出血或血肿并发症2.73%、死亡率1.49%,均明显优于经经股动脉急诊PCI组,差异有统计学意义(P<0.05)。结论急性ST段抬高型心肌梗死患者行急诊PCI时,桡动脉途径穿刺更加安全、有效。

Objective To explore the influence of different surgical approaches of emergency PCI on patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective analysis of 511 cases with STEMI who were treated with emergency PCI,and the cases were divided into transradial group(n=403) and the transfemoral artery group(n=108).The average day of stay,their echocardiogram within one week,the intraoperative and postoperative puncture complications and adverse cardiac events were observed in the two groups.Results The average length of stay,the intraoperative ventricular fibrillation incidence,immediate blood flow TIMI3 grade,ejection fraction,local bleeding or hematoma complications and the mortality rate with transradial emergency PCI were significantly better than with transfemoral artery emergency PCI.There was statistical significance(P<0.05).Conclusion The radial puncture is safe and more effective when patients with STEMI undergo emergency PCI.