老年冠心病患者经桡动脉冠状动脉造影后即行支架植入术治疗的临床疗效

摘要

目的 观察老年冠心病患者经桡动脉冠状动脉造影后即行支架植入术治疗的临床疗效.方法 选取2017年1月—10月商洛市商南县医院心内科收治的老年冠心病患者60例,根据治疗方案分为对照组与观察组,每组30例.对照组患者经股动脉冠状动脉造影后即行支架植入术治疗,观察组患者经桡动脉冠状动脉造影后即行支架植入术治疗.比较两组患者X线暴露时间、血管穿刺时间、造影时间、手术时间、术后住院时间、特殊指引导管使用率、经皮冠状动脉内球囊扩张(PTCA)使用率、双钢丝使用率、局部血管并发症发生率、支架植入成功率、手术前后西雅图心绞痛调查量表(SAQ)评分.结果 两组患者手术时间比较,差异无统计学意义(P>0.05);观察组患者X线暴露时间、血管穿刺时间长于对照组,造影时间、术后住院时间短于对照组(P<0.05).两组患者双钢丝使用率、支架植入成功率、动静脉瘘发生率比较,差异无统计学意义(P>0.05);观察组患者特殊指引导管使用率、PTCA使用率高于对照组,血肿、假性动脉瘤发生率低于对照组(P<0.05).术前两组心绞痛发作情况、疾病认知程度、治疗满意度、心绞痛稳定状态、躯体活动受限程度评分比较,差异无统计学意义(P>0.05);术后观察组患者心绞痛发作情况、疾病认知程度、治疗满意度、心绞痛稳定状态、躯体活动受限程度评分高于对照组(P<0.05).结论 老年冠心病患者经桡动脉冠状动脉造影后即行支架植入术治疗的临床疗效较好,有利于缩短术后住院时间,提高生活质量,降低局部血管并发症发生率.%Objective To observe the clinical effect of stent implantation immediately after transradial coronary angiography in treating elderly patients with coronary heart disease.Methods From January 2017 to October 2017,a total of 60 elderly patients with coronary heart disease were selected in the Department of Cardiology,Shangnan County Hospital, Shangluo,and they were divided into control group and observation group according to therapeutic regimens,each of 30 cases. Patients in control group received stent implantation immediately after transfemoral coronary angiography,while patients in observation group received stent implantation immediately after transradial coronary angiography. X-ray exposure time, vascular puncture time,angiography time,duration of operation,postoperative hospital stays,usage rates of specific guide catheter,PTCA and double-wire,incidence of local vascular complications,success rate of stent implantation,SAQ score before and after operation were compared between the two groups.Results No statistically significant differences of duration of operation was found between the two groups(P>0.05);X-ray exposure time and vascular puncture time in observation group were statistically significantly higher than those in control group,while angiography time and postoperative hospital stays in observation group were statistically significantly shorter than those in control group(P<0.05). No statistically significant differences of usage rate double-wire,success rate of stent implantation or incidence of arterio-venous fistula was found between the two groups(P>0.05);usage rates of specific guide catheter and PTCA in observation group were statistically significantly higher than those in control group,while incidence of hematoma and false aneurysm in observation group was statistically significantly lower than that in control group,respectively(P<0.05). No statistically significant differences of attack of angina pectoris score,disease cognition score,treatment satisfaction score,angina pectoris stability score or physical limitation score was found between the two groups before operation(P>0.05),while attack of angina pectoris score,disease cognition score, treatment satisfaction score,angina pectoris stability score and physical limitation score in observation group were statistically significantly higher than those in control group after operation(P<0.05).Conclusion Stent implantation immediately after transradial coronary angiography has good clinical effect in treating elderly patients with coronary heart disease,is helpful to shorten the postoperative hospital stays,improve the quality of life,reduce the risk of local vascular complications.