经肱动脉行冠状动脉介入的临床效果研究  

Brachial Artery Puncture Coronary Intervention:A Clinical Research

作　　者：陈然[1] 汤长春[1] 关贤颂[1] 刘赵云[1] 赵杨程 

机构地区：[1]湖南省长沙市中心医院,410004

出　　处：《中国全科医学》2012年第35期4124-4125,共2页Chinese General Practice

摘　　要：目的探讨经肱动脉穿刺行冠状动脉介入的可行性和安全性。方法选择我院心血管介入中心2012年3月—2012年5月收治的59例需行经皮选择性冠状动脉介入的患者为研究对象。随机分为两组:经肱动脉穿刺组(28例)和经桡动脉穿刺组(31例),比较两组患者的穿刺成功率、动脉穿刺时间及血管痉挛、皮下淤血、皮下血肿、神经受损发生率。结果经肱动脉穿刺组手术成功率较经桡动脉穿刺组升高(92.9%和87.1%),平均动脉穿刺时间较经桡动脉穿刺组缩短〔(2.5±0.6)min和(4.5±1.4)min〕,差异均有统计学意义(P<0.05)。但经肱动脉穿刺组血管痉挛、皮下淤血、皮下血肿、神经受损发生率均较经桡动脉穿刺组增多,差异有统计学意义(P<0.05)。结论经肱动脉途径容易穿刺不易发生血管痉挛,但并发症较多,从安全角度上来说不宜作为冠状动脉造影介入的首选途径。Objective To explore the feasibility and safety of brachial artery puncture coronary intervention in treat- ment of coronary artery disease. Methods 59 patients needing brachial artery puncture coronary intervention, admitted from March to May of 2012, were divided randomly into groups A （n = 28, receiving brachial artery puncture）, B （n = 31, receiv- ing transradial puncture）. The success rates of puncture, time of puncture and incidence of vasospasm, subcutaneous hemato- ma, suggillation, nervous injury were compared between 2 groups. Results The success rate was significantly higher （92. 9% vs. 87.1% ）, the average time of puncture was shorter [ （2. 5±0. 6） min vs. （4. 5±1.4） min ] in group A than in group B, the difference was significant （ P 〈 0. 05）. But the incidence of vasospasm, subcutaneous hemotoma, suggillation, nervous in- jury was higher in group A than in group B, the difference was significant （P 〈 0. 05）. Conclusion Brachial artery puncture, easy to perform, less prone to vasospasms but with more complications, should not be the preferred way to carry out coronary ar- teriography.

关 键 词：穿刺术 冠状动脉 血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]