超高龄冠心病患者经不同途径行PCI术后的远期疗效对比

摘要

Objective To explore the long-term curative effect of percutaneous coronary intervention(PCI)through radial artery and femoral artery for senile patients with coronary heart disease. Methods Retrospective analysis was made for the clinical data on the patients(n=213,all ≥85 years)with coronary heart disease to receive treatment in our hospital from Jan. 2006 to Dec. 2012,and they were divided into a radial artery group(n=124)and a femoral artery group(n=89)according to the PCI approach,so as to compare the success rate of the operation,general situation of the operation,complications and major adverse cardiovascular response in both groups. Resuits The total operation time,the amount of contrast agent,X-ray exposure time,postoperative hospitalization time,lesion characteristics,intervention condition,the success rate of operation,and the incidences of major adverse cardiovascular events between the two groups had no significant difference(p>0. 05);the puncture time of the radial artery group was longer than that of the femoral artery group,while the postoperative recovery time was shorter than the latter(p<0. 01);for changes in the interventional approach,the rate of the radial artery group was significantly higher than that in the femoral artery group(p<0. 01);the incidence of complications in the femoral artery group was significantly higher than that in the radial artery group(p<0. 05),and the number of cases of perioperative bleeding was significantly more than that in the radial artery group(p<0. 05). Conciusion The long-term effect of PCI through radial artery of senile patients with coronary heart disease is similar to that of PCI through femoral artery;PCI through radial artery needs a longer puncturing time and has a higher rate of changes in the interventional approach,but has fewer vascular complications.%目的：探讨超高龄冠心病患者桡动脉和股动脉途径行经皮冠状动脉介入（ PCI）治疗后的远期疗效。方法回顾性分析2006年1月~2011年12月在我院行冠状动脉介入治疗的≥85岁冠心病患者213例的临床资料，根据PCI入路分为桡动脉组124例和股动脉组89例，比较两组手术成功率、手术一般情况、并发症及主要不良心血管反应情况。结果桡动脉组在总手术时间、造影剂用量、X线曝光时间、术后住院时间、病变特征、介入情况、手术成功率、术后1年及术后2年的主要不良心血管事件发生率与股动脉组比较差异无统计学意义（ p>0.05）；桡动脉组穿刺时间长于股动脉组，术后卧床时间短于股动脉组（ p<0.01）；在更改介入途径上，桡动脉组比例高于股动脉组（ p<0.01）；股动脉组并发症的发生率高于桡动脉组（ p<0.05），围术期出血例数多于桡动脉组（ p<0.05）。结论超高龄冠心病患者经桡动脉途径PCI的远期疗效与经股动脉途径相似，其穿刺时间长，需更改介入治疗途径的比例高，但血管并发症少。