冠心病患者经桡动脉与股动脉介入治疗的随机对照研究

张万玲

（西安医学院附属北方医院心内科，陕西 西安，710043）

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摘要：

目的 探讨并对比经桡动脉与股动脉介入术在冠状动脉粥样硬化性心脏病（冠心病）患者中的应用效果。方法 以随机数字表法将82例行介入术的冠心病患者平分为桡动脉组（41例）与股动脉组（41例）。两组患者分别采取经桡动脉介入术与经股动脉介入术治疗。对比两组患者的手术指标（手术时间、穿刺成功率）、住院时间及并发症发生情况。结果 股动脉组患者手术时间明显低于桡动脉组（[51.22±26.19）min vs（.79.17±23.24）min]，住院时间长于桡动脉组［（5.41±1.22）d vs（.3.40±0.91）d］，差异均具有统计学意义（P<0.05）；股动脉组穿刺置管成功率明显高于桡动脉组（100.00% vs. 90.24%），并发症发生率明显高于桡动脉组（36.59% vs. 4.88%），差异均有统计学意义（P<0.05）。两组患者术中环扎均未见假性动脉瘤发生。结论 相较于股动脉介入术，经桡动脉穿刺介入术可以有效缩短住院时间，且并发症率低，可作为理想的穿刺路径推广于临床。

关键词：冠心病；股动脉；桡动脉；介入术

中图分类号：R541.4文献标志码：A文章编号：2096-1413(2016)25-0014-03

A randomized controlled study of patients with coronary heart disease treated by transradial and femoral artery interventional therapy
ZHANG Wan-ling
(Department of Cardiology, Northern Hospital, the Affiliated Hospital of Xi`an Medical University, Xi`an 710043, China)

ABSTRACT: Objective To discuss and contrast the effect of the patients with coronary heart disease (CHD) treated by transradial and transfemoral artery interventional therapy. Methods Eighty -two cases of coronary heart disease patients going to receive interventional therapy were divided into transradial group (41 cases) and transfemoral artery group (41 cases). The transradial group was treated by transradial coronary intervention, the transfemoral artery group was treated by transfemoral artery intervention. The indexes of operation (time of operation, success rate of puncture), the hospital stays and the complication between the two groups were compared. Results The time of operation in the transfemoral artery group was lower than that in the transradial group [(51.22±26.19) min vs.(79.17±23.24) min] (P<0.05), the hospital stays of the transfemoral artery group was longer than that of the transradial group [(5.41±1.22) d vs.(3.40±0.91) d] (P<0.05); the success rate of puncture of the transfemoral artery group was higher than that of the transradial group (100.00% vs. 90.24% ) (P<0.05); the incidence rate of complications of the transfemoral artery group were higher than that of the transradial group (36.59% vs. 4.88%) (P<0.05); there was no false aneurysm in the two groups during the loop fixation. Conclusion Compared with transfemoral artery intervention, transradial coronary intervention can effectively shorten the hospital stay, and has lower incidence rate of complications. It can be used as an ideal puncture path for clinical treatment.

KEYWORDS: coronary heart disease; femoral artery; radial artery; interventional therapy

参考文献：
[1] AGENO W,MANTOVANI LG,HAAS S,et al.XALIA: rationale and design of a non-interventional study of rivaroxaban compared with stan原 dard therapy for initial and long -term anticoagulation in deep vein thrombosis[J].Thromb J,2014,12(1):1-7.
[2] 贺素媛,易欣,任珊,等.老年冠心病经桡动脉和经股动脉介入治疗Meta分析[J].临床误诊误治,2013,26(1):61-65.
[3] 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.
[4] FREUDENBERGER RS,SCHWARZ RP JR,BROWN J,et al.Rationale, design and organisation of an efficacy and safety study of oxypurinol added to standard therapy in patients with NYHA class III - IV congestive heart failure[J].Expert Opin Investig Drugs,2004,13(11):1509-1516.
[5] DMYTRIW A,TERBRUGGE K,KRINGS T,et al.The role of interventional therapy in head and neck arteriovenous malformations [J].J Neurointerv Surg,2014,6(1):A34-A35.
[6] ZUCHOWSKI B,KACZMAREK K,SZUMOWSKI L,et al.Interventional treatment of atrial fibrillation-contemporary methods and perspectives [J].Expert Rev Med Devices,2014,11(6):595-603.
[7] MORRIS RK,DANIELS J,DEEKS J,et al.The challenges of interventional trials in fetal therapy[J].Arch Dis Child Fetal Neonatal Ed,2014,99 (6):448-450.
[8] 张正海,郭金成,张立新,等.经桡动脉和股动脉途径行冠状动脉介入治疗疗效的对比研究[J].实用心脑肺血管病杂志,2013,21(11):29-30.
[9] 李兴升,陈庆伟,王志刚,等.冠状动脉造影和血管成形术诊治老年冠心病:经桡动脉与经股动脉途径对比[J].中国介入影像与治疗学,2011,8(4):259-262.
[10] 许长存,刘培敏,任国成.经桡动脉与股动脉入径介入治疗冠心病的对比研究[J].中国病案,2009,10(3):47-48.
[11] 熊永红,惠永明,张骥,等.经桡动脉途径行冠状动脉介入治疗618例分析[J].心肺血管病杂志,2010,29(4):280-283.
[12] CHEN YP,CHEN YG,JIANG F,et al.Correlation and interventional embolization therapy of posterior intercostal arteries-induced hemoptysis [J].Genet Mol Res,2014,13(2):4252-4259.
[13] 黄业清,翁羡吾,杨立华,等.经桡动脉与股动脉入径介入诊疗冠心病的对比研究[J].微创医学,2009,4(5):536-538.
[14] 黄伟光,吴同果,韦建瑞,等.老年冠心病经桡动脉与股动脉途径介入治疗的对比研究[J].国际医药卫生导报,2009,15(20):17-20.
[15] 李子彬,刘宁,方咸宏.经桡动脉与经股动脉途径行经皮冠状动脉介入治疗急性心肌梗死的对比研究[J].实用心脑肺血管病杂志,2011,19(4):523-525.
[16] 周全,许春平,潘少勇.不同年龄段老年患者经桡动脉和股动脉途径行经皮冠状动脉介入治疗的对比分析[J].中国全科医学,2012,15(23):2623-2625.