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目的观察老年急性冠状动脉综合征(ACS)患者经桡动脉穿刺途径冠状动脉介入治疗(PCI)的可行性、近期疗效及并发症的发生情况。方法选择年龄70岁以上因ACS住院接受PCI术的老年患者,术前经检查桡动脉搏动良好,Allen试验阳性,适宜行桡动脉置管,并选择经桡动脉穿刺PCI者51例为桡动脉组,对照组97例为同时期年龄70岁以上采取经股动脉穿刺PCI的ACS者(股动脉组)。观察两组PCI成功率和近期临床疗效以及与穿刺有关的并发症的发生率,记录和统计患者术后绝对卧床时间和住院天数。结果两组血管病变特征基本相同。桡动脉组PCI的成功率为94.1%,股动脉组为96.9%,两组相比差异无统计学意义(P>0.05)。术中造影剂用量和X线曝光时间两组差异无统计学意义(P>0.05)。术后随访两组心功能和主要心血管事件发生率差异无统计学意义(P>0.05)。但与穿刺有关的并发症的发生率桡动脉组(2.0%)显著低于股动脉组(21.7%)(P<0.01)。桡动脉组术后平均绝对卧床时间和平均住院天数均明显短于股动脉组(分别P<0.01和P<0.05)。结论与经股动脉穿刺相比,老年ACS患者经桡动脉穿刺途径PCI具有相同的疗效,但术后患者卧床时间短,恢复快,与穿刺有关的并发症明显减少。
Objective To observe the feasibility, short-term curative effect and complication of radial artery percutaneous coronary intervention (PCI) in elderly patients with acute coronary syndrome (ACS). Methods Elderly patients over 70 years of age who were hospitalized for ACS undergoing ACS were enrolled in this study. Radial artery pulsation was good preoperatively, Allen test was positive, radial artery catheterization was appropriate, and 51 patients undergoing radial artery puncture were selected as radial artery group , 97 cases in the control group were ACS patients (femoral artery group) who underwent femoral artery puncture PCI at the same age over 70 years. The success rate of PCI and the recent clinical curative effect and the incidence of complication associated with puncture were observed. The absolute postoperative bed stay and hospital stay of patients were recorded and counted. Results The two groups of vascular lesions were basically the same. The success rate of PCI in the radial artery group was 94.1% and in the femoral artery group was 96.9%. There was no significant difference between the two groups (P> 0.05). Intraoperative contrast agent dosage and X-ray exposure time was no significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of cardiac function and major cardiovascular events between the two groups after operation (P> 0.05). However, the incidence of puncture-related complications in the radial artery group (2.0%) was significantly lower than that in the femoral artery group (21.7%) (P <0.01). The average absolute bed time and hospital stay in the radial artery group were significantly shorter than those in the femoral artery group (P <0.01 and P <0.05, respectively). Conclusion Compared with the femoral artery puncture, PCI of the elderly patients with ACS through radial artery puncture have the same curative effect, but the postoperative patients stay in bed for a short time and recover quickly, and the complications associated with puncture are significantly reduced.