经桡动脉冠状动脉造影同时行肾动脉造影可行性的探讨  

Combined coronary and renal angiographies through transradial approach

作　　者：季晓君[1,2] 王军[2] 林斌[2] 杨德业[3] 

机构地区：[1]温州医学院研究生部,325000 [2]温州市第二人民医院心内科,325000 [3]温州医学院附属第一医院心内科

出　　处：《中国医师进修杂志》2010年第10期35-38,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨经桡动脉冠状动脉造影同时行肾动脉造影的可行性和安全性。方法选择2007年8月至2009年4月住院经桡动脉予5FTIG共用导管行冠状动脉造影检查患者320例，同时行。肾动脉造影，其中20例患者直接前送TIG共用导管（桡动脉TIG共用导管组）行左右肾动脉造影，300例患者换用5FMP—A1造影导管到达肾动脉开口行左右肾动脉造影（桡动脉MP—A1导管组）。以2004年1月至2009年4月经股动脉途径同时行冠状动脉和肾动脉造影患者625例作为对照（股动脉JR导管组），观察各组。肾动脉造影成功率、总操作时间、造影剂用量、并发症情况。结果桡动脉MP．AI导管组肾动脉造影成功率为97．0％（291／300），股动脉JR导管组为98．4％（615／625），均显著高于桡动脉TIG共用导管组的40．0％（8／20）（e〈0．01）。桡动脉MP-A1导管组总操作时间（32．21±3．37）rain，造影剂用量（52．72±7．91）ml，股动脉JR导管组总操作时间（30．78＂±3．23）min。造影剂用量（51．88±7．22）ml，两组总操作时间及造影剂用量比较差异均无统计学意义（P〉0．05）。桡动脉TIG共用导管组造影剂用量（51．72±10．11）ml，与其他两组比较差异无统计学意义（P〉0．05），但其总操作时间（26．42±4．31）min，明显短于其他两组（P〈0．05）。经桡动脉途径造影患者术后并发症发生率（0．9％，3／320）少于经股动脉途径（3．0％，19／625）（P〈0．05）。结论在目前经桡动脉途径行冠状动脉造影普遍开展的情况下，经同途径使用5FMP-A1造影导管行肾动脉造影安全可行，并发症少，成功率高于直接使用TIG共用导管行肾动脉造影。Objective To investigate the feasibility and safety of combined coronary and renal angiographies through transradial approch. Methods Three hundred and twenty patients in hospital from August 2007 to April 2009 who underwent combined coronary and renal angiographies through transradial approach were included in this study. Renal artery angiography of 300 cases was done by 5 FMP-A1 catheter （MP-A1 group）,and 20 cases was done by TIG catheter （TIG group）. Control group had 625 patients in hospital from January 2004 to April 2009 who underwent combined coronary and renal angiographies through transfemoral approach. The achievement ratio,operating time, dosage of contrast agent and complication of angiography were observed. Results The achievement ratio was higher in MP-A1 group [97.0%（291/300） ] and control group [98.4%（615/625） ] than that in TIG group [40.0%（8/20） ]（P〈 0.01 ）. The operating time was （32.21 ± 3.37） rain and the dosage of contrast agent was （52.72 ± 7.91 ） ml in MP-A1 group,and it was （30.78 ± 3.23） min and （51.88 ± 7.22） ml in control group respectively. There was no significant difference between two groups （P 〉 0.05 ）. The operating time was （26.42 ± 4.31 ） min and the dosage of contrast agent was（51.72 ± 10.11 ） ml in TIG group. There was significant difference in the operating time between TIG group and the others groups （P 〈 0.05）. The complications of angiography through transradial approach （0.9%, 3/320） were less than those through transfemoral approach （3.0% ,19/625）（P 〈0.05）. Conclusions Renal artery angiography through transradial approach by 5 F MP-A1 catheter（ 125 centimeter） is safe and has minor complication. The achievement ratio of transradial approach for renal artery angiography by 5F MP-A 1 catheter is higher than that by TIG catheter.

关 键 词：心血管造影术 桡动脉 肾动脉 冠状血管 

分 类 号：R541.4[医药卫生—心血管疾病]