摘要
目的探讨合并慢性左心衰竭的老年冠心病患者经桡动脉途径介入治疗的优势及安全性。方法选择121例合并慢性左心衰竭的老年(年龄>65岁)冠心病患者,其中男性79例,女性42例,平均年龄(76±6.4)岁。分为经股动脉介入治疗组(对照组51例)和经桡动脉介入治疗组(桡动脉组70例)。观察并对比如下指标:X线曝光时间,术后卧床时间,与穿刺相关的并发症发生率(出血、血肿、无脉征、动-静脉瘘等),下肢深静脉血栓形成,血管进入失败率,术后卧床期间急性左心衰竭的发生率,体循环及肺循环栓塞的发生率。结果桡动脉组X线曝光时间平均(47.8±21.3)min,对照组平均(40.1±24.8)min(P>0.05);桡动脉组术后卧床时间平均(3.3±1.9)h,对照组平均(22.5±8.1)h(P<0.001);桡动脉组穿刺相关的并发症发生率为2.8%,对照组为5.7%(P<0.05);桡动脉组术后下肢深静脉血栓形成发生率为0,对照组3.9%(P<0.05);桡动脉组血管进入失败率为2.8%,对照组为5.7%(P<0.05);卧床期间急性左心衰的发生率桡动脉组为1.4%,对照组为8.5%(P<0.01),桡动脉组体循环栓塞发生率为0,对照组为3.9%(P<0.01),桡动脉组肺栓塞的发生率为0,对照组为1.4%(P<0.05)。住院期间两组无一例发生死亡。结论对于合并慢性左心衰竭的老年冠心病患者的冠状动脉介入治疗,经桡动脉和股动脉两种径路均是安全可行的。
Objective To investigate the advantage and safety of transradial approach（TRA） PCI for elderly CHD patients with chronic heart failure. Methods 121 elderly （age 〉 65 yrs）CHD patients with chronic heart failure （79 males and 42 females, with mean age of 76 ± 6.4 yrs）who were admitted to this department for PCI were enrolled in this study. The patients were randomized to TRA group and trans-femoral approach group（control）. A doctor blind to the study was appointed to collect the indicators as follows： X-ray exposure time, post-PCI bed-staying time, complication rates related to the puncture such as puncture site bleeding, hematoma, radial pulselessness, puncture site artery-venous fistula, leg deep venous thrombosis, vascular access failure rates and acute left heart failure（LHF） rates related to post-PCI bed-staying. Results The X-ray exposure time was 47.8 ± 21.3 rain in TRA group and 40.1 ± 24.8 rain in control group（ P 〉 0.05） ; post-PCI bed-staying time was 3.3 ± 1.9 h in TRA group and 22.5 ± 8.1 h in the control（ P 〈 0.001） ; complication rate was 1.7 % in TRA group and 6.3 % in the control（ P 〈 0.05） ; leg deep venous thrombosis rates were 0 vs 4%（ P 〈0.05）; vascular access failure rates were 0 vs 4%（ P 〈0.01）; acute LHF rates were 1.7% vs 8%（ P 〈0.01）.There was no in-hospital death in the two groups. Conclusions Both TRA-PCI and trans-femoral PCI for elderly CHD patients with chronic heart failure are feasible and safe.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2006年第8期537-539,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
