硝苯地平对经尺动脉入径行PCI患者血管痉挛的影响  

Effects of nifedipine on vasospasm in patients undergoing trans-ulnar artery approach PCI

作　　者：杨红[1] 刘全未[2] 李雪云[3] 

机构地区：[1]眉山市第二人民医院血管内科,四川仁寿620500 [2]内江市第二人民医院心内科 [3]眉山市第二人民医院心内科

出　　处：《西南国防医药》2016年第9期1023-1025,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨硝苯地平对经尺动脉入径行冠状动脉介入治疗(PCI)者动脉穿刺及介入治疗途中尺动脉痉挛风险的影响。方法将112例经尺动脉入径行PCI的心血管疾病患者分成A、B两组,各56例。B组直接予以经皮尺动脉入径PCI治疗;A组于术前舌下含服硝苯地平,再行经皮尺动脉入径PCI治疗。比较两组服药前(T0)、服药后5 min(T1)、服药后20 min(T2)时的尺动脉内径变化情况,记录患者一次穿刺成功情况、穿刺时间,以及动脉穿刺及介入治疗途中尺动脉痉挛发生情况。结果(1)A组患者舌下含服硝苯地平后,尺动脉管径逐渐增大,在T2时较T0时有显著差异,也大于同时间B组(P<0.05);而B组尺动脉管径无显著变化(P>0.05);(2)A组一次穿刺成功率为85.71%,显著高于B组的66.07%(P<0.05);B组平均穿刺用时显著长于A组(P<0.05);(3)A组尺动脉穿刺及介入治疗过程中,血管痉挛发生率分别为3.57%和5.36%,显著低于B组的17.86%和21.43%(P<0.05)。结论经尺动脉入径行PCI前,术前舌下含服硝苯地平可有效扩张血管,降低穿刺时及术中尺动脉痉挛风险,提高手术安全性。Objective To explore the effects of nifedipine on the risk of ulnar artery spasm during arterial puncture and interventional therapy in patients undergoing trans-ulner artery approach percutaneous coronary intervention （PCI）. Methods A total of 112 patients with cardiovascular diseases treated with trans-ulner artery approach PCI were divided into groups A and B （n=56, respectively）. Group B was directly treated with trans-ulner artery approach PCI while group A with sub-lingual nifedipine before operation, then trans-ulner artery approach PCI. The changes in the inner diameters of ulnar arteries in the two groups before taking medicine（T0）, 5min （T1） after taking medicine, 20min （T2） after taking medicine were compared. The success rate of one-time puncture, puncture time and incidence of ulnar arterial spasm during arterial puncture and interventional therapy in the two groups were recorded, Results（1）The ulnar artery diameter in group A increased gradually after sub-lingual nifedipine; there was significant difference between the diameters at T2 and To ; the diameters in group A were greater than those in group B at the same time （P 〈 0.05）; the ulnar artery diameters in group B has no significant difference （P 〉 0.05）. （2）The success rate of one-time puncture in group A （85.71%） was significantly higher than that in group B （66.07%） （P 〈 0.05）; and the mean time of puncture in group B was significantly longer than that in group A （P 〈 0.05）. （3）The incidence rates of ulnar arterial spasm during ulnar arterial puncture and interventional therapy in group A（3.57% and 5.36% ） were significantly lower than those in group B （17.86% and 21.43%） （P 〈 0.05）. Conclusion Sub-lingual nifedipine before trans-ulner artery approach PCI can effectively expand blood vessels and reduce the risk of ulnar arterial spasm during puncture and operation, and improve the safety of operation.

关 键 词：硝苯地平 尺动脉 冠状动脉 介入 血管痉挛 

分 类 号：R541.4[医药卫生—心血管疾病]