曹竣 蔡珍芝 陈颖

摘 要 目的：研究经远端桡动脉途径介入治疗冠心病的临床效果。方法：将72例冠心病患者随机分为对照组和观察组各36例，对照组经桡动脉入路行冠脉介入治疗，观察组经远端桡动脉入路行冠脉介入治疗，两组在治疗期间均给予替罗非班治疗。比较两组的穿刺成功率，血脂、炎性指标和不良反应发生率。结果：观察组的穿刺成功率高于对照组；不良反应发生率低于对照组（P<0.05）。两组的血脂、炎性指标比较，差异无统计学意义（P>0.05）。结论：冠心病介入治疗选择经远端桡动脉入路途径，可以提高穿刺成功率，降低不良反应发生率。

关键词 替罗非班 经远端桡动脉入路 冠心病

中图分类号：R654.3； R543.31 文献标志码：B 文章编号：1006-1533（2021）23-0064-03

Application study of interventional treatment of coronary heart disease via distal radial artery

CAO Jun1， CAI Zhenzhi2， CHEN Ying3（1. Department of Cardiology； 2. Department of Rehabilitation； 3. Department of Imaging Intervention， the Hospital of Ganzhou City， Ganzhou 341000， China）

ABSTRACT Objective： To study the clinical effect of interventional treatment of coronary heart disease via distal radial artery. Methods： Seventy-two patients with coronary heart disease were randomly divided into a control group and an observation group with 36 cases each. The control group underwent coronary intervention via radial artery approach while the observation group via the distal radial artery approach， and both groups were given tirofiban during the treatment. The puncture success rate， the blood lipid levels， the inflammatory indexes and the incidence of adverse reactions were compared between the two groups. Results： The puncture success rate was significantly higher and the incidence of adverse reactions was lower in the observation group than the control group （P<0.05）. There were no statistically significant differences between the two groups in blood lipid level and inflammatory indexes after treatment （P>0.05）. Conclusion： The puncture success rate can be increased and the incidence of adverse reactions can be reduced when the interventional treatment of coronary heart disease chooses the distal trans-radial artery access.

KEY WORDS tirofiban； distal trans-radial artery access； coronary heart disease

冠心病的治療中介入治疗是较为有效的方法，而在介入治疗的过程中经桡动脉是首选路径，与传统的股动脉入路比较，桡动脉具有非常明显的优势，桡动脉处于浅表的位置，周围无重要的组织器官[1]，但是该路径在实际使用过程中还是存在一些问题，会导致桡动脉痉挛、内膜撕裂以及血栓、夹层和穿孔等问题，其中发生率较高的为桡动脉痉挛，而且进行反复穿刺之后还会造成桡动脉的狭窄以及阻塞，而术后的加压处理则会造成肢体的麻木和疼痛[2]，因此需要选择更加有效的穿刺路径。经远端桡动脉介入治疗作为一种新型的介入治疗途径，在实施之后可以避免出现上述问题，同时在穿刺过程中给予替罗非班，能够起到良好的抗炎等效果，表明经远端桡动脉介入治疗实施效果较好[3]。……