经桡动脉应用MAC指引导管行急诊冠状动脉造影和介入治疗的可行性

发布时间：2018-01-14 01:32

  本文关键词：经桡动脉应用MAC指引导管行急诊冠状动脉造影和介入治疗的可行性　出处：《首都医科大学学报》2015年01期 　论文类型：期刊论文

  更多相关文章： 心肌梗死 血管成形术 桡动脉 导管

【摘要】：目的探讨经桡动脉应用MAC3.5指引导管行急性ST段抬高心肌梗死(ST-segment elevated myocardial infarction,STEMI)患者冠状动脉造影和介入治疗的安全性和有效性。方法前瞻性单中心、随机对照研究,自2011年8月至2012年4月,150例发病12 h内,拟行经皮桡动脉急诊介入治疗的STEMI患者按1∶1比例随机分成MAC组(75例)和对照组(75例)。MAC组直接应用MAC3.5指引导管行冠状动脉造影和介入治疗,对照组用多功能造影导管完成冠状动脉造影后选择指引导管行介入治疗。主要终点是操作时间和透视时间,次要终点是穿刺部位合并症和30 d复合事件(包括所有原因的死亡、心肌梗死或非冠状动脉搭桥相关的出血)。采用意向性治疗分析。结果两组基线资料相似。MAC组和对照组桡动脉交换到股动脉的比例(4.0%vs 3.5%),首选指引导管更换比例(10.7%vs 9.3%),局部麻醉至冠状动脉造影完成时间[(7.2±2.6)min vs(7.1±2.3)min]和门囊时间[(86.1±39.4)min vs(88.8±36.3)min],差异均无统计学意义(P均0.05)。与对照组相比,MAC组的急诊介入治疗(percutaneous coronary intervention,PCI)操作时间、总操作时间和透视时间均明显缩短[(23.7±9.6)min vs(29.0±12.0)min,P=0.003;(30.9±10.4)min vs(36.4±12.3)min,P=0.004;(8.4±2.1)min vs(10.2±4.9)min,P=0.007]。穿刺部位血肿两组各3例,保守治疗后好转。30 d复合事件发生率,MAC组和对照组分别为6.6%(5/75)和5.3%(4/75)(χ2=0.118,P=0.731)。结论经桡动脉应用MAC3.5指引导管行STEMI患者造影和介入治疗能缩短操作时间和透视时间,该方法能否对临床事件产生有益的影响还需要进一步证实。
[Abstract]:Objective to explore the application of transradial MAC3.5 guiding catheter for acute ST elevation myocardial infarction (ST-segment elevated myocardial infarction, STEMI) the efficacy and safety of coronary angiography and interventional treatment of patients. Methods a prospective single center, randomized study, from August 2011 to April 2012, 150 patients underwent 12 h. Percutaneous radial artery interventional treatment of STEMI patients by 1: 1 ratio were randomly divided into MAC group (75 cases) and control group (75 cases) group.MAC direct application of MAC3.5 guiding catheter coronary angiography and interventional therapy, the control group with multifunction catheter coronary arteriography after guiding catheter interventional therapy the main end point. Operation time and fluoroscopy time, the secondary end point was the puncture site complications and 30 d composite events (including all causes of death, myocardial infarction or coronary artery bypass graft related bleeding). 鐢ㄦ剰鍚戞，

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