摘要
目的 比较经传统和远端桡动脉穿刺途径行冠状动脉造影(coronary artery angiography,CAG)和或经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的临床指标,探讨远端桡动脉穿刺的效果及安全性。方法 选择2020年3月至2020年10月在安徽医科大学第二附属医院行CAG和或PCI治疗的患者100例,随机分成传统桡动脉组50例和远端桡动脉组50例,比较两组患者之间的临床指标。结果 两组患者的年龄、性别等基线资料比较,差异无统计学意义(P=0.980,P=0.840)。与远端桡动脉组患者比较,传统桡动脉组患者的穿刺成功率较高(100%vs. 86%,P=0.012),且用时较少[(3.80±1.62)min vs.(4.63±2.04)min,P=0.031]、穿刺次数减少[(1.14±0.72)次vs.(2.23±1.08)次,P=0.024],差异有统计学意义;相反,远端桡动脉穿刺术后包扎时间少(4 h vs. 6 h,P=0.022),且相关并发症、术后2 h穿刺部位疼痛评分及桡动脉闭塞率远远低于传统桡动脉组[22%vs. 4.7%,P=0.018;(4.36±2.24)分vs.(1.24±0.78)分,P=0.002;10%vs. 0,P=0.059]。通过对试验亚组分析得出低体质量、老年、女性患者远端桡动脉穿刺成功率低。结论 远端桡动脉穿刺较传统部位穿刺平均耗时延长不到1 min,成功率略降低,但其显著减少了加压包扎时间,术后穿刺部位疼痛减少,患者的舒适度增加,并且其相关并发症明显减少,可作为首次行PCI治疗患者的首选穿刺途径。
Objectives To compare the clinical data of distal transradial access and transradial access for coronary artery angiography(CAG)or percutaneous coronary intervention(PCI),and to discuss the advantages and clinical practicability of distal transradial access.Methods Totally 100 patients from March 2020 to October 2020 undergoing CAG or PCI in Second Affiliated Hospital of Anhui Medical University were selected and divided into experimental group with artery cannulation by distal radial artery and control group with artery cannulation transradial randomly.Clinical data of the two groups were compared.Results There was no significant difference in age and gender between distal transradial access group and transradial access group(P=0.980,P=0.840).Compared with distal radial artery group,the success rate in transradial access group was higher(100%vs.86%,P=0.012),the puncture duration was less[(3.80±1.62)min vs.(4.63±2.04)min,P=0.031]as well as the times of puncture attempts(1.14±0.72 vs.2.23±1.08,P=0.024)in raditional radial artery group.On the contrary,the pressure time was less after distal radial artery puncture(4 h vs.6 h,P=0.022),while the related complications,the numerical rating scale(NRS)score at 2 hours and radial artery occlusion rate after distal radial artery puncture were far lower than those of traditional radial artery group(22%vs.4.7%,P=0.018;4.36±2.24 vs.1.24±0.78,P=0.002;10%vs.0,P=0.059).Through the analysis of the subgroup test,it was concluded that low success rate of distal radial artery puncture in low body mass,elderly,and female patients.Conclusions The average duration of distal radial artery puncture is longer than(≤1 min)of traditional puncture,and the success rate is slightly reduced,but it significantly reduces the pressure duration,reduces the pain at the puncture site,increases the comfort of patients,and significantly reduces its related complications,which can be routinely carried out in patients who are first undergoing PCI.
作者
王凯
胡广全
盛建龙
何非
程诚
WANG Kai;HU Guangquan;SHENG Jianlong;HE Fei;CHENG Cheng(Department of Cardiovascular Medicine,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)
出处
《岭南心血管病杂志》
CAS
2023年第6期585-589,共5页
South China Journal of Cardiovascular Diseases
基金
安徽省自然科学基金(项目编号:1808085QH235)
安徽医科大学基础与临床合作研究提升计划(项目编号:NO.2020xkjT036)。
关键词
冠状动脉疾病
远端桡动脉穿刺
冠状动脉造影
血管成形术
经腔
经皮冠状动脉
coronary artery disease
distal radial artery puncture
coronary angiography
percutaneous coronary inter-vention intervention
