不同途径介入治疗急性心肌梗死的对照研究-东南大学学报医学版

不同途径介入治疗急性心肌梗死的对照研究

单位：江苏大学附属医院心内科, 江苏镇江 212001

分类号：R541.4

出版年·卷·期（页码）：2012·31·第一期（60-62）

摘要：

目的:比较不同途径急诊经皮冠状动脉介入治疗(PCI)对ST段抬高的急性心肌梗死的安全性和有效性。方法:收集254例发病≤12 h 的ST段抬高的急性心肌梗死患者的临床资料,比较经桡动脉急诊PCI(TRA组,n=182)与经股动脉急诊PCI(TFA组,n=72)患者的手术操作、住院情况以及随访期主要不良心脏事件(MACE)发生率。结果:两组穿刺成功率、穿刺至首次球囊扩张时间、手术成功率、住院和随访期间MACE发生率差异均无统计学意义(P>0.05)。TRA组手术时间短[(36.1±16.3)min vs (40.5±15.1)min,P=0.049),依从性高(81.9% vs 26.4%,P<0.005),血管并发症明显减少(5.5% vs 34.7%,P<0.005),住院时间缩短[(9.2±3.0)d vs (10.8±4.2)d,P=0.003]。结论:在强化抗栓条件下,相对于股动脉途径,急诊经桡动脉PCI有相似的有效性及安全性,且并发症和住院日更少。

Objective: To contrast safety and efficacy of primary percutaneous coronary intervention(PCI) by different approach for acute ST-elevation myocardial infarction(STEMI). Methods: The research concluded 254 patients with STEMI within 12 h, 182 patients were treated by transradial approach PCI(TRA group) and 72 patients by transfemoral approach PCI(TFA group). The procedure and major adverse cardiac event(MACE) in hospital and for 6 months follow-up period were compared. Results: The results demonstrated that successful rates of puncture and procedure, puncture to first balloon-inflation time, and the MACE in hospital and for 6 months follow-up period were similar between the two groups. However, the procedure time was(36.1±16.3) min in TRA group vs (40.5±15.1) min in TFA group(P=0.049). The compliance of puncture was significant higher in TRA group compared with TFA group(81.9% vs 26.4%,P<0.005), and the vascular complication was significant decreased in TRA group(5.5% vs 34.7%, P<0.005), the hospital stay was shorter in TRA group[(9.2±3.0) days vs (10.8±4.2) days, P=0.003]. Conclusion: With aggressive antithrombotic treatment, emergent transradial approach primary PCI is safe and effective, which is similar to transfemoral approach, moreover less vascular complication and shorter hospital stay.

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