联合地尔硫和硝酸甘油防治桡动脉痉挛的有效性和安全性观察  

Combination use of diltiazem and nitroglycerin in preventing radial artery spasm in performing coronary angiography: observation of its efficacy and safety

作　　者：胡文志[1] 杨季明[1] 

机构地区：[1]南京医科大学第二附属医院心内科,210011

出　　处：《介入放射学杂志》2014年第6期474-476,共3页Journal of Interventional Radiology

摘　　要：目的对比研究经桡动脉路径行冠状动脉造影时桡动脉应用硝酸甘油及联合地尔硫和硝酸甘油防治桡动脉痉挛的有效性及安全性。方法 2012年12月—2013年6月对200例患者经绕动脉路径行冠状动脉造影。在成功置入动脉鞘管后在鞘管内分别注入硝酸甘油200μg(硝酸甘油组,100例)或联合硝酸甘油200μg和地尔硫2 mg(联合药物组,100例),用心电血压监护仪记录患者注入药物前、注入后2、5、15和30 min的血压和心电情况,并观察桡动脉痉挛以及局部情况。结果联合药物组5例发生桡动脉痉挛,低于硝酸甘油组的13例,组间差异有统计学意义(P<0.05)。联合药物组和硝酸甘油组对心率和心电的影响差异无统计学意义(P>0.05)。结论经桡动脉介入治疗时,联合应用硝酸甘油和地尔硫可以更有效防治桡动脉痉挛的发生,且对心率、血压和心电无明显影响。Objective To investigate the efficacy and safety of combination use of diltiazem and nitroglycerin in preventing radial artery spasm in performing coronary angiography via radial artery access. Methods During the period from Dec. 2012 to June 2013 at authors’ hospital, coronary angiography via radial artery access was carried out in a total of 200 patients. The patients were randomly divided into 2 groups： nitroglycerin group （n = 100） and combination group （n = 100）. After successful placement of catheter sheath 200 μg of nitroglycerin was injected through the sheath in the patients of the nitroglycerin group, while 200 μg of nitroglycerin together with 2 mg diltiazem was injected through the sheath in the patients of the combination group. The heart rate , blood pressure and electrocardiogram were recorded with an electrocardio-pressure monitor before the injection as well as at 2, 5, 15 and 30 minutes after the injection. The occurrence of radial artery spasm and patient ’s general condition were also under observation. Results Radial artery spasm occurred in 5 patients of the combination group , while it occurred in 13 patients of the nitroglycerin group, the difference between the two groups was statistically significant （P 0.05）. Conclusion For the coronary intervention via radial artery access , combination use of diltiazem and nitroglycerin can more effectively prevent the occurrence of radial artery spasm. Besides , combination use of diltiazem and nitroglycerin has no obvious effect on the heart rate , the blood pressure and the electrocardiogram.

关 键 词：痉挛 桡动脉 地尔硫 硝酸甘油 冠状动脉造影 

分 类 号：R543.5[医药卫生—心血管疾病]