经左 右桡动脉冠状动脉造影的对比研究  

Transradial artery coronary angiography through the left or the right radial approach in 580 patients

作　　者：姚朱华[1] 张伟 李鸿梅[1] 阿不利米提 吾买尔江 瓦哈浦 崔景秋[1] 冀秋娣[1] 

机构地区：[1]天津医科大学总医院,天津300052 [2]喀什地区第二人民医院,新疆喀什844000

出　　处：《中国实用内科杂志》2008年第7期571-572,共2页Chinese Journal of Practical Internal Medicine

摘　　要：目的比较经左、右桡动脉两种途径行诊断性冠状动脉造影在手术成功率、X线透视时间、手术操作时间以及血管痉挛发生率等方面的差异。方法选择2003年3月至2006年10月天津医科大学总医院和喀什地区第二人民医院临床诊断为冠状动脉粥样硬化性心脏病患者580例,经桡动脉行选择性冠状动脉造影(CAG)。其中227例经右桡动脉,353例经左桡动脉进行操作。观察操作过程、选用导管数量、手术时间、X线曝光时间、造影成功率、血管并发症等方面。结果经左、右桡动脉两种途径行CAG操作,首次穿刺成功率差异无统计学意义(P>0.05);经左桡动脉较经右桡动脉选用导管数量多(P<0.05)、手术时间短(P<0.05)、X线曝光时间短(P<0.05)、造影成功率高(P<0.01);两组间血管痉挛发生率差异无统计学意义(P>0.05);术后均无桡动脉闭塞发生。结论经左桡动脉行冠状动脉造影导管控制方便,操作时间短,造影成功率高,与经右桡动脉途径操作具有同样的可行性和较少的血管并发症。Objective To investigate the safety and efficacy of transradial artery coronary angiography through the left or the right radial approach. Methods All 580 patients between March 2003 and October 2006 were divided into two groups. The fight radial group （ 227 patients） with 5 F universal Terumo catheter. The left radial group （353 patients） with 5 F JL 4 and JR 4 Goodman catheter. Results The technical success rate was higher in left radial group than in the fight radial one（P 〈0. 01 ）. The number of coronary catheters used was lower in the right radial group（P 〈0. 05）. The procedural duration was longer with fight radial approach than with left radial（ P 〈 0. 05 ）. X-ray exposure was shorter in the left radial group than in the fight radial group（ P 〈 0. 05 ）. The occurrence of spasm was not different between the two groups （P 〉 0. 05 ）. Conclusion Transradial coronary angiography can be performed with a high success rate and low rate of complication, being more comfortable with the patients. The left radial approach may provide increased procedural efficacy for coronary angiography compared to the right radial approach.

关 键 词：冠状动脉粥样硬化性心脏病 桡动脉 冠状血管造影术 

分 类 号：R5[医药卫生—内科学]