Bach R, Espinola-Klein C, Ozbek C, Jung F, Schieffer H
Kardiologische Gemeinschaftspraxis im Ambulanten Herzzentrum Dresden.
Dtsch Med Wochenschr. 1993 Nov 19;118(46):1669-76. doi: 10.1055/s-2008-1059500.
All major complications within four weeks after diagnostic cardiac catheterization (DCCA; n = 4,778) or percutaneous transluminal coronary angioplasty (PTCA; n = 3,073) were analysed prospectively in 7,851 patients (5,769 men, 2,082 women; mean age 59.4 [16-88] years). There were 116 such complications in 114 patients, 46 (0.9%) after DCCA, 70 (2.3%) after PTCA. 76% of all complications occurred during the first two days after the procedure: bleeding in 29 patients, false aneurysms in 15, arterial occlusions in 12, venous ones in three, cerebral ischaemia in 12, fulminant pulmonary emboli in three, cardiac complications in 27, and others in 15. There were five deaths in connection with a DCCA, 18 with PTCA. Complications were twice as common in women as in men (DCCA: 1.5% vs 0.7%, P < 0.05; PTCA: 4.2% vs 1.7%, P < 0.001). Complications after DCCA were more frequent in those aged over 55 years (1.2% vs 0.3%, P < 0.05); after PTCA they were more frequent in those aged over 65 years (4.1% vs 1.3%, P < 0.05). Other risk factors for complications were: peripheral arterial occlusive disease for arterial occlusion (P < 0.001), high heparin dosage with DCCA (P < 0.05), and additional venous puncture with DCCA (P < 0.01).
对7851例患者（5769例男性，2082例女性；平均年龄59.4[16 - 88]岁）进行了前瞻性分析，这些患者在诊断性心导管插入术（DCCA；n = 4778）或经皮腔内冠状动脉成形术（PTCA；n = 3073）后四周内出现的所有主要并发症。114例患者出现了116种此类并发症，DCCA后有46例（0.9%），PTCA后有70例（2.3%）。所有并发症的76%发生在术后的前两天：29例出血，15例假性动脉瘤，12例动脉闭塞，3例静脉闭塞，12例脑缺血，3例暴发性肺栓塞，27例心脏并发症，15例其他并发症。DCCA相关死亡5例，PTCA相关死亡18例。并发症在女性中比男性常见两倍（DCCA：1.5%对0.7%，P < 0.05；PTCA：4.2%对1.7%，P < 0.001）。DCCA后的并发症在55岁以上人群中更常见（1.2%对0.3%，P < 0.05）；PTCA后的并发症在65岁以上人群中更常见（4.1%对1.3%，P < 0.05）。并发症的其他危险因素包括：动脉闭塞的外周动脉闭塞性疾病（P < 0.001）、DCCA时高剂量肝素（P < 0.05）以及DCCA时额外的静脉穿刺（P < 0.01）。
