中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
6期
676-678
,共3页
徐荣%郭金成%马长生%王国忠%高国旺%张正海%王宇平%朱芙丽
徐榮%郭金成%馬長生%王國忠%高國旺%張正海%王宇平%硃芙麗
서영%곽금성%마장생%왕국충%고국왕%장정해%왕우평%주부려
心肌梗死%血管成形术%经皮冠状动脉介入%冠状动脉造影术
心肌梗死%血管成形術%經皮冠狀動脈介入%冠狀動脈造影術
심기경사%혈관성형술%경피관상동맥개입%관상동맥조영술
Myocardial infarction%Angioplasty%Percutaneous coronary intervention%Coronary angiography
目的:评价经桡动脉路径应用单根MAC指引导管在急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者中行急诊冠状动脉造影和介入治疗(percutaneous coronary intervention,PCI)的安全性和有效性。方法入选2013年8月至2013年12月北京通州区潞河医院心内科经急诊室-CCU-导管室途径连续收治的STEMI患者72例,其中男性53例,女性19例,平均年龄(59.1±12.2)岁。随机将患者分为2组,对照组(36例)和MAC组(36例)。对照组常规冠状动脉造影后再用MAC3.5指引导管介入治疗,MAC组直接应用MAC3.5指引导管行冠状动脉造影和介入治疗。记录导管室门-囊(cathlab door to balloon,C2B)时间、门-囊(door to balloon,D2B)时间、造影剂用量、总的操作时间、透视时间、放射剂量面积乘积和穿刺部位并发症等。结果两组患者在PCI术前/后TIMI血流分级、药物使用、介入操作等方面差异无统计学意义(P均>0.05)。与对照组比较,MAC组C2B时间[(22.58±9.94)minvs.(18.38±5.43)min],总的操作时间[(37.65±12.51)minvs.(29.64±11.26)min],透视时间[(10.68±4.42)minvs.(7.80±4.24)min]均减少,差异具有统计学意义(P均<0.05)。MAC组较对照组放射剂量面积乘积降低,差异具有统计学意义(P<0.05)。两组穿刺部位局部血肿比例差异无统计学意义(2.78%vs.2.78%,P>0.05)。结论经桡动脉应用单根MAC3.5指引导管同时行STEMI患者急诊冠状动脉造影和PCI能够缩短C2B时间、透视时间,介入治疗安全有效。
目的:評價經橈動脈路徑應用單根MAC指引導管在急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者中行急診冠狀動脈造影和介入治療(percutaneous coronary intervention,PCI)的安全性和有效性。方法入選2013年8月至2013年12月北京通州區潞河醫院心內科經急診室-CCU-導管室途徑連續收治的STEMI患者72例,其中男性53例,女性19例,平均年齡(59.1±12.2)歲。隨機將患者分為2組,對照組(36例)和MAC組(36例)。對照組常規冠狀動脈造影後再用MAC3.5指引導管介入治療,MAC組直接應用MAC3.5指引導管行冠狀動脈造影和介入治療。記錄導管室門-囊(cathlab door to balloon,C2B)時間、門-囊(door to balloon,D2B)時間、造影劑用量、總的操作時間、透視時間、放射劑量麵積乘積和穿刺部位併髮癥等。結果兩組患者在PCI術前/後TIMI血流分級、藥物使用、介入操作等方麵差異無統計學意義(P均>0.05)。與對照組比較,MAC組C2B時間[(22.58±9.94)minvs.(18.38±5.43)min],總的操作時間[(37.65±12.51)minvs.(29.64±11.26)min],透視時間[(10.68±4.42)minvs.(7.80±4.24)min]均減少,差異具有統計學意義(P均<0.05)。MAC組較對照組放射劑量麵積乘積降低,差異具有統計學意義(P<0.05)。兩組穿刺部位跼部血腫比例差異無統計學意義(2.78%vs.2.78%,P>0.05)。結論經橈動脈應用單根MAC3.5指引導管同時行STEMI患者急診冠狀動脈造影和PCI能夠縮短C2B時間、透視時間,介入治療安全有效。
목적:평개경뇨동맥로경응용단근MAC지인도관재급성ST단태고형심기경사(ST segment elevation myocardial infarction,STEMI)환자중행급진관상동맥조영화개입치료(percutaneous coronary intervention,PCI)적안전성화유효성。방법입선2013년8월지2013년12월북경통주구로하의원심내과경급진실-CCU-도관실도경련속수치적STEMI환자72례,기중남성53례,녀성19례,평균년령(59.1±12.2)세。수궤장환자분위2조,대조조(36례)화MAC조(36례)。대조조상규관상동맥조영후재용MAC3.5지인도관개입치료,MAC조직접응용MAC3.5지인도관행관상동맥조영화개입치료。기록도관실문-낭(cathlab door to balloon,C2B)시간、문-낭(door to balloon,D2B)시간、조영제용량、총적조작시간、투시시간、방사제량면적승적화천자부위병발증등。결과량조환자재PCI술전/후TIMI혈류분급、약물사용、개입조작등방면차이무통계학의의(P균>0.05)。여대조조비교,MAC조C2B시간[(22.58±9.94)minvs.(18.38±5.43)min],총적조작시간[(37.65±12.51)minvs.(29.64±11.26)min],투시시간[(10.68±4.42)minvs.(7.80±4.24)min]균감소,차이구유통계학의의(P균<0.05)。MAC조교대조조방사제량면적승적강저,차이구유통계학의의(P<0.05)。량조천자부위국부혈종비례차이무통계학의의(2.78%vs.2.78%,P>0.05)。결론경뇨동맥응용단근MAC3.5지인도관동시행STEMI환자급진관상동맥조영화PCI능구축단C2B시간、투시시간,개입치료안전유효。
Objective To review the safety and efficacy of single transradial guiding MAC applied in coronary angiography (CAG) and percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods The patients (n=72, male 53, female 19 and average age: 59.1±12.2) were chosen from Aug. 2013 to Dec. 2013, and then divided into control group and MAC group (eachn=36). The control group was treated with routine CAG and then with MAC3.5 for PCI, and MAC group was treated directly with MAC3.5 for CAG and PCI. The time of C2B, time of D2B, contrast doseage, the total operation time, radiological time, product of radiological dose area and complications at puncture site were recorded.Resutls The difference in TIMI flow grading, drug administration and intervention operation had no statistical significance between 2 groups before/after PCI (allP>0.05). Compared with control group, in MAC group time of C2B, [(22.58±9.94) minvs. (18.38±5.43) min], the total operation time, [(37.65±12.51) minvs. (29.64±11.26) min] and radiological time [(10.68±4.42) minvs. (7.80 ±4.24) min] decreased (allP<0.05). The product of radiological dose area decreased in MAC group compared with control group (P<0.05). The difference in percentage of patients with hematoma at puncture site had no statistical significance between 2 groups (2.78%vs. 2.78%,P<0.05).Conclusion The application of single transradial guiding MAC can shorten time of C2B and radiological time, and is safe and effective in patients with STEMI undergone CAG and PCI.