[摘要] 目的 高危冠心病经桡动脉途径行冠状动脉介入治疗术临床疗效、心功能及预后分析。 方法 选取2015年5月~2017年5月在我院经桡动脉途径行冠状动脉介入治疗的64例高危冠心病患者临床资料,患者经桡动脉行PCI术,比较本组患者治疗前后疗效指标及心功能、并发症。 结果 本组手术时间(1.58±0.68)h、住院时间(5.26±2.13)d,穿刺成功率96.88%(62/64)、手术成功率95.31%(61/64);患者治疗后LVEF(65.17±2.13)%、LVEDD(51.23±7.32)mm、LVESD(50.05±7.64)mm优于治疗前(P /6/view-10694651.htm
[关键词] 高危冠心病;桡动脉;冠脉介入;心功能
[中图分类号] R541 [文献标识码] A [文章编号] 1673-9701(2018)01-0019-03
Clinical effectiveness, cardiac function and prognosis analysis of radial artery access in percutaneous coronary intervention in patients with high risk coronary heart disease
KE Fusheng1 QI Liping2
1.Beijing Changping Hospital,Beijing 102200,China;2.Beijing Changping Hospital of Traditional Chinese Medicine,Beijing 102200,China
[Abstract] Objective To investigate the clinical effectiveness, cardio function and prognosis analysis of radial artery access in percutaneous coronary intervention(PCI) in patients with high risk coronary heart disease. Methods Physical records of 64 patients with high risk coronary heart disease in our hospital from May 2015 to May 2017 who had been through radial artery access in PCI were collected. Indicators of clinical effectiveness, cardiac function were compared between before and after the treatment. Complications were recorded. Results The operation duration was (1.58±0.68)h. Hospitalization time was(5.26±2.13)d. The rates of successful puncture and successful operation were 96.88%(62/64) and 95.31%(61/64)respectively. LVEF(65.17±2.13)%, LVEDD(51.23±7.32)mm, LVESD(50.05±7.64)mm of patients after operation were significantly higher than those before operation(P医学别称“缺血性心脏病”,是由冠状动脉粥样硬化致血管窄小,促使心肌缺血缺氧而引起的心功能异常,休克、胸痛、心绞痛及全身乏力等为其临床症状,少数患者发病可猝死,严重危害患者生命健康[1]。药物治疗、冠状动脉旁路移植术、经皮冠状动脉介入术(PCI)均是冠心病常见治疗方法,以PCI术最为常用,根据其介入手术路径不同,分为经桡动脉介入术(TRI)、经股动脉介入术(TFI)两种[2]。为探讨经桡动脉途径介入治疗的效果,我院选取诊治的64例经桡动脉途径介入治疗的高危冠心病患者为研究对象,现报道如下。 1 资料与方法
1.1 一般资料
研究对象选择2015年5月~2017年5月在我院行PCI术治疗的64例高危冠心病患者。纳入标准:均存在心肌缺血、心绞痛等冠心病临床症状,经冠脉造影显示冠脉病变狭窄>75%,心功能分级≥3级,Allen试验结果呈阳性。排除标准:介入术禁忌证者,心功能分级统计学方法
使用SPSS21.0分析数据,计量资料以(x±s)表示,采用t检验,计数资料以[n(%)]表示,采用χ2检验,P 综上所述,经桡动脉途径行冠状动脉介入治疗高危冠心病的手术成功率高,有效改善心功能,且并发症发生少,生活质量明显改善,具有一定临床应用与研究价值。
[参考文献]
[1] 代聚平.经桡动脉途径介入诊断与治疗高危冠心病患者的临床效果观察[J].中医临床研究,2017,9(4):133-134.
[2] 王娟.经股动脉和桡动脉两种不同途径介入治疗冠心病对比研究[J].四川?t学,2016,37(3):283-286.
[3] 黄海源,韦宝敏,周柳芳,等.高危冠心病患者经桡动脉及经股动脉介入治疗术的疗效比较[J].右江民族医学院学报,2014,36(6):838-839.
[4] Girinsky T,M'Kacher R,Lessard N,et al.Prospective coronary heart disease screening in asymptomatic Hodgkin lymphoma patients using coronary computed tomography angiography: Results and risk factor analysis[J].International Journal of Radiation Oncology,Biology,Physics,2014,89(1):59-66.
[5] Krul ES,Mauro Lulu,Mukherjea Ratna. Justification for soy protein to still have a category 'A' coronary heart disease risk reduction health claim[J].Trends in Food Science &Technology,2014,36(1):55-58.
[6] 郑彩虹,董惠翔,黄战军,等.经股动脉与经桡动脉径路介入术治疗冠心病的临床效果对比观察[J].临床医学,2016,36(12):27-29.
[7] 叶武成,高彩丽,叶鹏,等.经股动脉与经桡动脉入路经皮冠状动脉介入术治疗高龄冠心病患者的临床疗效比较[J].实用心脑肺血管病杂志,2016,24(1):45-47.
[8] 蔡裕福,谢晓霞,陈文威,等.桡动脉入路行经皮冠状动脉介入术治疗老年冠心病并慢性左心衰竭患者疗效观察[J].中华实用诊断与治疗杂志,2015,29(3):265-267.
[9] 吕永成.高危冠心病患者经桡动脉及经股动脉介入治疗术的疗效比较[J].广西医科大学学报,2014,31(1):123-125.
[10] 王共华,任文清.高危冠心病患者经桡动脉及经股动脉介入治疗术的疗效比较[J].航空航天医学杂志,2015, 26(10):1218-1219.
[11] 刘雪,马淑梅.超高龄冠心病患者经不同途径行PCI术后的远期疗效对比[J].西南国防医药,2015,(2):166-168.
[12] 古拜热木?艾买尔.经股动脉与桡动脉两种路径介入治疗冠心病的安全性与有效性对比分析[J].中西医结合心脑血管病杂志,2014,(10):1191-1193.
[13] 刘杲,缪金龙,许岭平,等.经桡动脉和股动脉途径行经皮冠状动脉介入治疗高龄冠心病患者疗效比较[J].安徽医学,2016,37(6):696-698.
[14] 冷利华,黄文胜,汪念东,等.经桡动脉途径和股动脉途径行冠心病介入治疗的回顾性分析[J].临床军医杂志,2014,42(5):451-453.
[15] 卢思稼,韦伟,马建林,等.经股动脉途径和桡动脉途径穿刺介入术治疗高龄冠心病的临床对比[J].中国老年学杂志,2015,35(9):2523-2525.
(收稿日期:2017-09-29)