【摘要】 目的评价桡动脉入路冠脉介入术(PCI)治疗急性心肌梗死(AMI)的优缺点及可行性。方法选择2006年8月至2008年8月在本院住院的85例AMI并经桡动脉介入(TRI)患者,并与以往经股动脉介入(TFI)67例AMI患者进行对比。观察两组介入治疗时间和并发症情况。结果TRI组85例患者中,单支病变46例(54.1%),多支病变39例(45.9%),其中完全闭塞性病变28例(32.9%);TFI组67例患者中,单支病变40例(59.7%),多支病变27例(40.3%),其中完全闭塞病变21例(31.3%),两组病例基本临床特征比较,差异无统计学意义(P>0.05)。从局部麻醉到手术结束,TRI组为(54±23)min,TFI组为(47±19)min,两组比较差异无统计学意义(P>0.05)。TRI组血管穿刺成功率为98.8%,TFI组血管穿刺成功率为100%,手术成功率分别为96.5%和100%。两组手术并发症发生率分别为4.7%(4/85)和23.9%(16/67),其中TRI组发生桡动脉痉挛1例,局部血肿3例。而TFI组出现局部血肿6例,动静脉瘘1例,假性动脉瘤4例,迷走神经反射5例,两组差异有统计学意义(P<0.01)。结论采用经桡动脉和经股动脉行冠状动脉介入治疗,均具有较高的成功率,但TRI组并发症发生率明显低于TFI组,故经桡动脉行PCI值得在临床上推广。更多还原

【Abstract】 Objective To observe the effect and clinical availability of coronary intervention through radial artery in the treatment of acute myocardial infarction(AMI).Methods From 2006 to 2008,85 cases of AMI were intervened transradial artery(TRI group).The procedure success rates and complications were recorded and compared with the results of transfemoral intervention(TFI group) in 67 cases of AMI in 2004-2006.Results There were 46 patients who had single vessel disease,39 patients had multi-vessel disease in TRI group.Among all of them,28 cases had complete coronary artery occlusion.In TFI group,there were 40 patients who had single vessel disease,27 patients had multi-vessel disease,among them,21 cases had complete coronary artery occlusion.And there were no significant differences in major clinical characteristics between two groups(P>0.05).There was no statistical difference in operation time and success rate between TRI group and TFI group((54±23)min vs(47±19)min,96.5% vs 100%,P>0.05).Compared with TFI group,TRI group had less complications:1 cases occurred the spasm of radial artery,3 cases had hematoma.In TFI group,6 cases occurred hematoma,1 cases had arterial venous fistula,4 case had false aneurysm,5 cases had vagal reaction.And there was a statistical difference between two groups(P< 0.01).Conclusion TRI and TFI showed similar high success rate,but the incidence of complications in TRI group were lower than those in TFI group.TRI is worth spreading.更多还原