摘要
目的探讨经桡动脉和股动脉行冠状动脉介入的优缺点。方法回顾分析2004年6月到2005年6月在我院接受冠状动脉造影术和支架植入术的患者235例。按股动脉途径(125例)或桡动脉途径(110例)分为两组。比较两组造影使用的导管数、动脉穿刺成功率、X线照射时间,支架植入的手术操作时间、成功率、并发症发生率。结果①冠状动脉造影:经桡动脉、股动脉行冠状动脉造影血管穿刺成功率分别为94.5%、100%(P<0.05);X线照射时间分别为(3.35±1.25)min和(2.72±0.58)min(P<0.05);造影成功率分别为93.6%、100%(P<0.05)。②PTCA或支架植入:经桡动脉、股动脉植入单个支架的手术操作时间分别为(21.43±6.21)min、(15.24±4.15)min(P<0.05);成功率分别为92.7%、97.6%(P>0.05);血管并发症发生率分别为2.7%、11.2%(P<0.01)。结论①经桡动脉行冠状动脉造影及支架植入术不需卧床、损伤小、止血方便、血管并发症少,为其优点。②经桡动脉行冠状动脉介入要求术者有较高的技术水平,血管穿刺失败和桡动脉痉挛是影响造影和支架植入成功的重要原因,且推送导管过程中需持续透视,增加了术者和患者X线照射时间。③无论从桡动脉入路还是从股动脉入路都以手术成功为最终目的,选择何种路径当根据患者的具体情况确定。
Objective To evaluate the advantage and disadvantage of transradial approach for coronary intervention compared to transfemoral approach. Methods Two hundreds and thirty-five patients undergoing coronary angiography and intracoronary stent implantation include 125 cases operated transfemoral and 110 cases transradial. In both group, the number of catheters used in operation, success rate of transartery puncture, X ray exposure time, operation time of implanting stent, success rate of stent implantation and the vessel complications were compared retrospectively. Results ①Coronary angiography., in radial group and femoral group, the success rate of transartery puncture, X-ray exposure time and the success rate of CAG were separately 94.5% vs 100%, （3.35±1.25） min vs （2.72±0.58） min and 93.6% vs 100%. ②Intracoronary stent implantation; in radial group and femoral group, the average operation time for implanting single stent, success rate of operation and peripheric vessel complications were separately （21.43 ±6.21） min vs （15.24 ± 4. 15） min, 92.7% vs 97.6% and 2.7% vs 11.2%. Conclusion Contrast with transfemoral approach, transradial access for CAG and intracoronary stent implantation has such advantage as less peripheral vessel complications, less injury, convenient for hemostasis and doesn＇t need the patients keeping the bed, but it request the operator be more skilled and X-ray exposure time of operator and patients is longer. Radial artery spasm and failing to transradial puncture are two major reasons for the failure of operation. So we conclude transradial approach can be chosen as an alternative to transfemoral approach for coronary intervention, but it can＇t replaced completely transfemoral approach.
出处
《中国介入影像与治疗学》
CSCD
2006年第3期169-171,共3页
Chinese Journal of Interventional Imaging and Therapy
