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目的:比较经股动脉和桡动脉入路冠状动脉介入治疗(percutaneous coronary intervention,PCI)术中周围血管并发症的发生率,为其临床诊治提供参考。方法:分析2014年7月至2016年12月在我院心血管介入治疗中心进行冠状动脉造影及介入治疗的780例患者的临床资料,比较周围血管并发症发生情况。结果:经股动脉途径471例,经桡动脉途径309例。经股动脉途径总体并发症发生率13.2%,高于经桡动脉途径的4.5%,差异有统计学意义(P<0.001)。经股动脉途径出血并发症发生率为7.9%,高于经桡动脉途径2.6%,差异有统计学意义(P=0.002)。经股动脉途径患者重大并发症(后腹膜血肿、假性动脉瘤、动静脉瘘、动脉夹层形成)发生率高于经桡动脉途径(2.1%vs 0%),但差异无统计学意义。结论:经股动脉途径冠状动脉介入治疗术围手术期周围血管并发症发生率高于经桡动脉途径,临床入路选择时需综合考虑。
Objective: To compare the incidence of peripheral vascular complications during percutaneous coronary intervention (PCI) via the femoral artery and radial artery and provide a reference for its clinical diagnosis and treatment. Methods: The clinical data of 780 patients who underwent coronary angiography and interventional treatment at the Cardiovascular Intervention Center of our hospital from July 2014 to December 2016 were analyzed. The incidence of peripheral vascular complications was compared. Results: There were 471 cases in the femoral artery and 309 cases in the radial artery. The overall incidence of complications through the femoral artery was 13.2%, which was significantly higher than that of the transradial approach (P <0.001). The incidence of bleeding complications through the femoral artery was 7.9%, which was higher than that of the transradial route by 2.6% (P = 0.002). The incidence of major complications (retroperitoneal hematoma, pseudoaneurysm, arteriovenous fistula, arterial dissection) in the femoral artery approach was higher than in the transradial approach (2.1% vs 0%), but the difference was not statistically significant. CONCLUSIONS: Perioperative peripheral vascular complications via the femoral artery approach for coronary artery intervention have a higher incidence of peripheral vascular complications than via the transradial approach. Consideration should be given to clinical options.