冠状动脉造影与经皮冠状动脉介入治疗术后外周血管并发症临床分析及处理  

Analysis and management of peripheral vascular complications after coronary angiography and percutaneous coronary intervention

作　　者：黄晏[1] 张锦[1] 李俨[1] 

机构地区：[1]兰州大学第一医院心内科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2007年第4期56-58,共3页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨冠状动脉造影与经皮冠状动脉介入术后外周血管并发症的发生率、原因和处理方法。方法分析经皮冠脉介入术后出现外周血管并发症患者的临床资料。结果5763例患者中118例(2.1%)发生外周血管并发症,其中穿刺部位单纯血肿84例(1.5%),假性动脉瘤28例(0.5%)。动静脉瘘6例(0.1%)。经皮冠状动脉介入术后外周血管并发症的发生率显著高于冠状动脉造影术后(2.9%与0.8%,P<0.05)。弹力绷带加压包扎结合超声指导下压迫修复的成功率为100%。结论经皮冠状动脉介入术后外周血管并发症并不少见,主要与穿刺方法不当、术者经验不足、女性、高龄及抗凝治疗有关。超声指导下压迫修复成功率较高。Objective To investigate the incidences, causes and managements of peripheral vascular complications after coronary angiography （CAG） and percutaneous coronary intervention （PCI）. Method Clinical data of patients with peripheral vascular complications after PCI were reviewed. Results Out of 5 763 cases, 118 cases （2.1%） had peripheral vascular complications, including local hematoma 84 cases （1.5%）, pseudoaneurysm 28 cases （0.5%） and arteriovenous fistula 6 cases （0.1%）, and the incidence of complications after PCI was higher than that after CAG （2.9% vs 0.8%, P 〈0.05）. The success repair rates were 100% after ultrasound-guided compression. Conclusions Peripheral vascular complications after PCI are not rare, and often associated with incorrect femoral artery punctures, inexperienced technicians, female and senior-aged patients, and anticoagulation treatments. Ultrasound-guided compression of these complications has higher success repair rates.

关 键 词：冠状动脉介入术 并发症 外周血管疾病 假性动脉瘤 动静脉瘘 

分 类 号：R541.4[医药卫生—心血管疾病]