杨溢 陆秀红 刘伟 秦孺子 何静 杨昱 胡川 张圭

[摘要] 目的：探讨经桡动脉途径和股动脉途径行老年冠心病介入治疗的疗效。方法：将我科2008年10月~2010年6月收治的90例需行冠状动脉介入治疗的老年冠心病患者，按穿刺途径分为桡动脉组和股动脉组，每组45例，比较两组患者的穿刺时间、手术操作时间、手术成功率、术后并发症、不适反应、X线曝光时间及住院时间。结果：桡动脉组与股动脉组手术操作时间、手术成功率、X线曝光时间方面比较，差异无统计学意义（P>0.05）。桡动脉组术后血管并发症、不适反应及住院时间方面显著少于股动脉组，穿刺时间长于股动脉组，差异有统计学意义（P<0.01或P<0.05）。结论：经桡动脉途径和股动脉途径都是治疗老年冠心病的良好方法，经桡动脉术后并发症及不适反应少，且住院时间短，相对增加患者的舒适度，值得临床推广应用。

[关键词] 桡动脉；股动脉；老年冠心病；介入治疗

[中图分类号] R541.4[文献标识码]Ａ [文章编号]1673-7210（2011）11（c）-043-02

Coronary interventional therapy for the elderly patients with coronary heart disease through transradial and transfemoral percutaneous

YANG Yi, LU Xiuhong, LIU Wei, Qin Ruzi, HE Jing, YANG Yu, HU Chuan, ZHANG Gui

Department of Gerontology, Guangdong Provincial Armed Forces Hospital, Guangdong Province, Guangzhou 510507, China

[Abstract] Objective: To assess the effectiveness and safety of transradial and transfemoral percutaneous coronary interventional therapy for the elderly patients with coronary heart disease. Methods: From October 2008 to June 2010, 90 elderly patients with coronary heart disease who should do coronary intervention, were randomly divided into radial artery group and femoral artery group according to puncture approaches, each group had 45 cases. Puncture time, operation time, surgical success rate, the postoperative complications, discomfort reaction, X-ray exposure time and length of hospitalization of the two groups were compared. Results: There was no significant difference of operation time, surgical success rate and X-ray exposure time between the two groups (P>0.05)，the rate of total vascular complications, discomfort reaction and hospitalization time of the radial artery group were less than those of femoral artery group (P<0.01), puncture time was longer than that of femoral artery group (P<0.05). Conclusion: In the elderly patients with coronary heart disease, transradial coronary angoplasty has the same success rate, but less postoperative complications and discomfort reaction and shorter hospitalization time compared with transfemoral approach. Transradial approach is a safe and feasible method.

[Key words] Radial artery; Femoral artery; Elderly coronary heart disease; Interventional treatment

冠状动脉粥样硬化性心脏病（简称冠心病）是慢性充血性心力衰竭的常见原因之一，被称为“人类健康的第一杀手”。随着我国老龄化步伐的加快，冠心病的发病率也在逐渐上升，且有年轻化的趋势。近年来，冠心病介入诊断和治疗以其诊断准确性高，疗效显著以及创伤小的特点已在我国迅速普及推广。经股动脉途径行冠状动脉介入治疗（PCI）是冠心病介入治疗的常用途径，但常有严重血管并发症及术后长时间卧床等缺点。经桡动脉入路行PCI具有损伤小、止血方便、血管并发症少，术后恢复快的特点[1]。经桡动脉途径行冠状动脉造影和介入治疗已被诸多医院列为首选途径。为了探讨对两种方法治疗……