实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
7期
78-80,81
,共4页
霍本良%吕长泳%潘庆丽%姜威峰%蒋杞英
霍本良%呂長泳%潘慶麗%薑威峰%蔣杞英
곽본량%려장영%반경려%강위봉%장기영
冠心病%心力衰竭%老年人%血管成形术, 气囊, 冠状动脉%疗效比较研究
冠心病%心力衰竭%老年人%血管成形術, 氣囊, 冠狀動脈%療效比較研究
관심병%심력쇠갈%노년인%혈관성형술, 기낭, 관상동맥%료효비교연구
Coronary disease%Heart failure%Aged%Angioplasty,balloon,coronary%Comparative %effectiveness research
目的：比较经股动脉入路和经桡动脉入路经皮冠状动脉介入术（ PCI ）治疗老年冠心病合并慢性左心衰竭患者的临床效果。方法选取开封市第二人民医院心血管内科2013年5月—2014年7月收治的224例老年冠心病合并慢性左心衰竭患者，根据手术入路不同分为TFI组（121例）和TRI组（103例）。 TFI组患者行经股动脉入路PCI治疗， TRI组患者行经桡动脉入路PCI治疗，两组患者治疗后均随访6个月。比较两组患者手术情况（穿刺时间、 X线暴露时间、手术时间、术后卧床时间）、手术成功率、穿刺部位并发症发生率、术后并发症发生情况（下肢深静脉血栓形成、肺栓塞、体循环栓塞、左心衰竭、腰背疼痛、排尿困难、腹胀、肢体疼痛）及复发率。结果 TFI组患者穿刺时间、 X线暴露时间、手术时间均短于TRI组，术后卧床时间长于TRI组（ P＜0.05）。 TFI组患者手术成功率为95.87％， TRI组患者手术成功率为93.20％，差异无统计学意义（ P＞0.05）。 TFI组患者穿刺部位并发症发生率为32.23％，高于TRI组的18.45％（P＜0.05）。两组患者术后下肢深静脉血栓形成、肺栓塞、体循环栓塞、肢体疼痛发生率比较，差异无统计学意义（ P＞0.05）； TFI组患者术后左心衰竭、腰背疼痛、排尿困难、腹胀发生率均高于TRI组（P＜0.05）。 TFI组患者术后6个月复发率为14.05％，高于TRI组的5.83％（P＜0.05）。结论经桡动脉入路PCI治疗老年冠心病合并慢性左心衰竭患者的临床效果与经股动脉入路PCI相当，但手术时间较长，术后并发症发生率较低。
目的：比較經股動脈入路和經橈動脈入路經皮冠狀動脈介入術（ PCI ）治療老年冠心病閤併慢性左心衰竭患者的臨床效果。方法選取開封市第二人民醫院心血管內科2013年5月—2014年7月收治的224例老年冠心病閤併慢性左心衰竭患者，根據手術入路不同分為TFI組（121例）和TRI組（103例）。 TFI組患者行經股動脈入路PCI治療， TRI組患者行經橈動脈入路PCI治療，兩組患者治療後均隨訪6箇月。比較兩組患者手術情況（穿刺時間、 X線暴露時間、手術時間、術後臥床時間）、手術成功率、穿刺部位併髮癥髮生率、術後併髮癥髮生情況（下肢深靜脈血栓形成、肺栓塞、體循環栓塞、左心衰竭、腰揹疼痛、排尿睏難、腹脹、肢體疼痛）及複髮率。結果 TFI組患者穿刺時間、 X線暴露時間、手術時間均短于TRI組，術後臥床時間長于TRI組（ P＜0.05）。 TFI組患者手術成功率為95.87％， TRI組患者手術成功率為93.20％，差異無統計學意義（ P＞0.05）。 TFI組患者穿刺部位併髮癥髮生率為32.23％，高于TRI組的18.45％（P＜0.05）。兩組患者術後下肢深靜脈血栓形成、肺栓塞、體循環栓塞、肢體疼痛髮生率比較，差異無統計學意義（ P＞0.05）； TFI組患者術後左心衰竭、腰揹疼痛、排尿睏難、腹脹髮生率均高于TRI組（P＜0.05）。 TFI組患者術後6箇月複髮率為14.05％，高于TRI組的5.83％（P＜0.05）。結論經橈動脈入路PCI治療老年冠心病閤併慢性左心衰竭患者的臨床效果與經股動脈入路PCI相噹，但手術時間較長，術後併髮癥髮生率較低。
목적：비교경고동맥입로화경뇨동맥입로경피관상동맥개입술（ PCI ）치료노년관심병합병만성좌심쇠갈환자적림상효과。방법선취개봉시제이인민의원심혈관내과2013년5월—2014년7월수치적224례노년관심병합병만성좌심쇠갈환자，근거수술입로불동분위TFI조（121례）화TRI조（103례）。 TFI조환자행경고동맥입로PCI치료， TRI조환자행경뇨동맥입로PCI치료，량조환자치료후균수방6개월。비교량조환자수술정황（천자시간、 X선폭로시간、수술시간、술후와상시간）、수술성공솔、천자부위병발증발생솔、술후병발증발생정황（하지심정맥혈전형성、폐전새、체순배전새、좌심쇠갈、요배동통、배뇨곤난、복창、지체동통）급복발솔。결과 TFI조환자천자시간、 X선폭로시간、수술시간균단우TRI조，술후와상시간장우TRI조（ P＜0.05）。 TFI조환자수술성공솔위95.87％， TRI조환자수술성공솔위93.20％，차이무통계학의의（ P＞0.05）。 TFI조환자천자부위병발증발생솔위32.23％，고우TRI조적18.45％（P＜0.05）。량조환자술후하지심정맥혈전형성、폐전새、체순배전새、지체동통발생솔비교，차이무통계학의의（ P＞0.05）； TFI조환자술후좌심쇠갈、요배동통、배뇨곤난、복창발생솔균고우TRI조（P＜0.05）。 TFI조환자술후6개월복발솔위14.05％，고우TRI조적5.83％（P＜0.05）。결론경뇨동맥입로PCI치료노년관심병합병만성좌심쇠갈환자적림상효과여경고동맥입로PCI상당，단수술시간교장，술후병발증발생솔교저。
Objective To compare the clinical effect of PCI in treating aged coronary heart disease patients complicated with chronic left heart failure between transfemoral approach and transradial approach.Methods From May 2013 to July 2014, a total of 224 aged coronary heart disease patients complicated with chronic left heart failure were selected in the Department of Cardiology, the Second People′s Hospital of Kaifeng, and they were divided into A group (n=121) and B group (n=103) according to surgical approaches.Patients of A group were treated by PCI through transfemoral approach, while patients of B group were treated by PCI through transradial approach, patients of both groups were followed-up for 6 months after surgery.Surgery situation ( including puncture time, X-ray exposed time, surgery duration and postoperative in-bed time) , surgical successful rate, incidence of siteofparacentesis complications and postoperative complications ( including lower extremity deep venous thrombosis, pulmonary embolism, systemic emboli, left heart failure, lumbago and back pain, dysuria, abdominal distension and limb pain) , and recurrence rate were compared between the two groups.Results Puncture time, X-ray exposed time and surgery duration of A group were statistically significantly shorter than those of B group, while postoperative in-bed time of A group was statistically significantly longer than that of B group ( P <0.05 ) . The surgical successful rate of A group was 95.87%, that of B group was 93.20%, the difference was not statistically significantly different (P>0.05).The incidence of siteofparacentesis complications of A group was 32.23%, was statistically significantly higher than that of B group of 18.45% (P <0.05).No statistically significant differences of lower extremity deep venous thrombosis, pulmonary embolism, systemic emboli or limb pain was found between the two groups ( P>0.05 ) , while the incidence of left heart failure, lumbago and back pain, dysuria and abdominal distension of A group were statistically significantly higher than those of B group (P<0.05).The recurrence rate of A group was 14.05%, was statistically significantly higher than that of B group of 5.83% ( P <0.05 ) . Conclusion The clinical effect of PCI in treating aged coronary heart disease patients complicated with chronic left heart failure is similar between transfemoral approach and transradial approach, while the surgery duration of PCI through transradial approach is relatively longer, but the incidence of postoperative complications is relatively lower.
