论文部分内容阅读
目的探讨经桡动脉途径介入治疗合并慢性左心衰竭的老年冠心病患者的优势及安全性。方法选择91例合并慢性左心衰竭的老年(>65岁)冠心病患者,其中男69例,女22例,平均年龄(76±6.7)岁。分为经股动脉介入治疗组(对照组41例)和经桡动脉介入治疗组(桡动脉组50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(出血、血肿、无脉征、动-静脉瘘等)发生率,下肢深静脉血栓形成,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(46.8±21.3)min,对照组平均(40.2±24.8)min,两组比较差异无统计学意义(P>0.05);桡动脉组术后卧床时间平均(3.4±1.9)h,对照组平均(22.5±8.1)h,两组比较差异有统计学意义(P<0.01);桡动脉组穿刺相关的并发症发生率为4.0%,对照组为9.8%,两组比较差异有统计学意义(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4.9%,两组比较差异有统计学意义(P<0.05);卧床期间急性左心衰竭的发生率桡动脉组为2.0%,对照组为9.8%,两组比较差异有统计学意义(P<0.01);桡动脉组体循环栓塞发生率为0,对照组为2.4%,两组比较差异有统计学意义(P<0.05);桡动脉组肺栓塞的发生率为0,对照组为2.4%,两组比较差异有统计学意义(P<0.05)。住院期间两组无1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,且经桡动脉途径具有更多的优势。
Objective To investigate the advantages and safety of transradial approach for elderly patients with coronary heart disease complicated with chronic left heart failure. Methods A total of 91 elderly patients (> 65 years old) with coronary heart disease and chronic left heart failure were enrolled, including 69 males and 22 females with an average age of 76 ± 6.7 years. The patients were divided into trans-femoral artery intervention group (control group, 41 cases) and transradial artery intervention group (50 cases, radial artery group). Observed and compared the following indicators: X-ray exposure time, postoperative bed rest time, complications associated with puncture (bleeding, hematoma, pulseless, arteriovenous fistula, etc.) incidence, deep vein thrombosis, postoperative bed rest The incidence of acute left heart failure, systemic and pulmonary embolism incidence. Results The radial exposure time was (46.8 ± 21.3) min in radial artery group and 40.2 ± 24.8 min in control group, with no significant difference between the two groups (P> 0.05) ± 1.9) h in the control group and 22.5 ± 8.1 h in the control group (P <0.01). The incidence of complications associated with radial artery puncture was 4.0% in the control group and 9.8% in the control group (P <0.05). The incidence of deep venous thrombosis in the radial artery group was 0 and 4.9% in the control group, there was significant difference between the two groups (P <0.05) The incidence of left heart failure was 2.0% in the radial artery group and 9.8% in the control group, with a significant difference between the two groups (P <0.01). The incidence of circulatory embolism in the radial artery group was 0% and in the control group was 2.4% (P <0.05). The incidence of pulmonary embolism in the radial artery group was 0, while that in the control group was 2.4%. The difference between the two groups was statistically significant (P <0.05). No one died in either group during hospitalization. Conclusion Coronary interventional therapy in elderly patients with CHD complicated with chronic left heart failure is viable both via radial artery and femoral artery and has more advantages via transradial approach.