目的:探讨高出血风险病人通过鼻烟壶处桡动脉与常规桡动脉两种途径行冠状动脉介入治疗的效果。方法:选取2019年10月—2021年10月就诊于我院行经皮冠状动脉介入治疗(PCI)和冠状动脉造影(CAG)治疗的病人,根据穿刺方式分为常规桡动脉组和...目的:探讨高出血风险病人通过鼻烟壶处桡动脉与常规桡动脉两种途径行冠状动脉介入治疗的效果。方法:选取2019年10月—2021年10月就诊于我院行经皮冠状动脉介入治疗(PCI)和冠状动脉造影(CAG)治疗的病人,根据穿刺方式分为常规桡动脉组和鼻烟壶处桡动脉组。比较两组病人的基线资料、造影使用剂量、手术时间、术后并发症、术后3 h数字疼痛评分(NRS)、住院时间、术后压迫时间。结果:两组病人的基线资料、住院时间、X线曝光时间、穿刺时间、手术成功率等比较,差异均无统计学意义(P>0.05),术后3 h NRS疼痛评分、穿刺次数、术后动脉压迫时间比较,差异有统计学意义(P<0.05)。两侧桡动脉内径和鼻烟壶处桡动脉内径呈明显的相关性(P<0.05)。结论:与经典桡动脉介入治疗相比,鼻烟壶处桡动脉介入治疗的住院天数、疼痛发生率、并发症发生率、术后动脉压迫时间显著减少。展开更多
BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA v...BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA vs RA during CAG.METHODS The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and Clinical-Trials.gov.Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included.The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation approach.RESULTS Three randomized control trials and 13 registered trials were identified.The two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was low.CONCLUSION For CAG,the DRA would be safer than the RA with comparable cannulation rates.Given the limited data,additional research,including studies with standard protocols,is necessary.展开更多
文摘目的:探讨高出血风险病人通过鼻烟壶处桡动脉与常规桡动脉两种途径行冠状动脉介入治疗的效果。方法:选取2019年10月—2021年10月就诊于我院行经皮冠状动脉介入治疗(PCI)和冠状动脉造影(CAG)治疗的病人,根据穿刺方式分为常规桡动脉组和鼻烟壶处桡动脉组。比较两组病人的基线资料、造影使用剂量、手术时间、术后并发症、术后3 h数字疼痛评分(NRS)、住院时间、术后压迫时间。结果:两组病人的基线资料、住院时间、X线曝光时间、穿刺时间、手术成功率等比较,差异均无统计学意义(P>0.05),术后3 h NRS疼痛评分、穿刺次数、术后动脉压迫时间比较,差异有统计学意义(P<0.05)。两侧桡动脉内径和鼻烟壶处桡动脉内径呈明显的相关性(P<0.05)。结论:与经典桡动脉介入治疗相比,鼻烟壶处桡动脉介入治疗的住院天数、疼痛发生率、并发症发生率、术后动脉压迫时间显著减少。
文摘BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for CAG.AIM To assess the efficacy and safety of the DRA vs RA during CAG.METHODS The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and Clinical-Trials.gov.Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included.The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation approach.RESULTS Three randomized control trials and 13 registered trials were identified.The two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was low.CONCLUSION For CAG,the DRA would be safer than the RA with comparable cannulation rates.Given the limited data,additional research,including studies with standard protocols,is necessary.
