Objective To evaluate the efficacy and safety of percutaneous coronary intervention (PCI) through radial artery approaches for elderly patients with acute coronary syndrome.Methods Clinical data of 228 elderly patients with acute coronary syndrome admitted to Department of Cardiovasology,the Second Xiangya Hospital of Central South University from April 2013 to December 2015 were analyzed retrospectively.All patients were divided into femoral artery group (121 cases) and radial artery group (107 cases) according to different intervention approaches.The exposure time of X-ray,puncture time,operation time,postoperative time in bed,postoperative hospital stay,dose of contrast agent,achievement ratio of puncture,achievement ratio of PCI between two groups were recorded.The incidence rate of major adverse cardiac event and complication of puncture site after operation of 1 month between two groups were compared.Results X-ray exposure time,operation time,contrast agent dosage,puncture success rate,PCI success rate between two groups were compared,with no statistical difference (P ＞ 0.05).The puncture time,postoperative bed time,postoperative hospital stay in radial artery group were significantly shorten than those in femoral artery group,with statistical differences (P ＜ 0.05).The incidence rate of major cardiovascular event between two groups after operation of 1 month was compared,with no statistical difference (P ＞ 0.05).The incidence rate of complication in radial artery group was significantly lower than that in femoral artery group,with statistical difference (P ＜ 0.05).Conclusion The efficacy of PCI through radial artery approaches and femoral artery approaches for elderly patients with acute coronary syndrome is similar,but PCI through radial artery approache has the characters of easy operation,short time in bed,fast recover,and few complication,which has good clinical feasibility and safety.%目的 评价经桡动脉冠状动脉介入(PCI)治疗用于高龄急性冠脉综合征患者的疗效和安全性.方法 回顾性分析2013年4月～2015年12月中南大学湘雅二医院心血管内科收治的高龄急性冠脉综合征患者228例的临床资料,根据介入途径的不同将所有患者分为股动脉组(121例)和桡动脉组(107例).记录两组患者X线曝光时间、穿刺时间、手术时间、术后卧床时间、术后住院时间、造影剂用量、穿刺成功率、PCI成功率,比较两组患者术后1个月主要心血管事件和穿刺部位并发症的发生率.结果 两组X线曝光时间、手术时间、造影剂用量、穿刺成功率、PCI成功率比较,差异无统计学意义(P＞0.05).桡动脉组穿刺时间、术后卧床时间、术后住院时间均显著短于股动脉组,差异有统计学意义(P＜0.05).两组术后1个月主要心血管事件发生率比较,差异无统计学意义(P＞0.05).桡动脉组穿刺部位并发症发生率显著低于股动脉组,差异有统计学意义(P＜0.05).结论 经桡动脉和经股动脉行PCI用于高龄急性冠脉综合征患者的疗效相当,但是经桡动脉行PCI操作方便,卧床时间短,恢复快,且并发症少,具有良好的临床可行性和安全性.
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