皮下注射硝酸甘油预防经桡动脉冠状动脉造影或介入术后桡动脉闭塞的临床效果  

Clinical efficacy of subcutaneous injection of nitroglycerin for prevention of radial artery occlusion after transradial coronary angiography/transradial coronary intervention

作　　者：陈武奇[1] CHEN Wu-qi(Department of Cardiovascular Disease , Guangdong Second Provincial People＇s Hospital , Guangzhou 510311 , China)

机构地区：[1]广东省第二人民医院心血管内科,广州市510317

出　　处：《广西医学》2018年第9期1054-1056,1093,共4页Guangxi Medical Journal

摘　　要：目的探讨桡动脉穿刺前加用皮下注射硝酸甘油预防经桡动脉冠状动脉造影(TRA)或经桡动脉冠状动脉介入(TRI)术后桡动脉闭塞的效果。方法选取TRA和TRI治疗的患者195例,随机分为观察组(n=99)和对照组(n=96),观察组桡动脉穿刺前用硝酸甘油500μg溶于生理盐水共0.5 ml皮下注射;对照组桡动脉穿刺前用生理盐水0.5 ml皮下注射。两组均于术毕拔出桡动脉鞘管后使用桡动脉止血器压迫止血。术后1 d、3周、4个月行彩色多普勒超声检查及桡动脉触诊,观察患者术侧桡动脉闭塞、相关不良反应的发生情况及血压和心率的变化。结果术后3周及4个月观察组患者的桡动脉闭塞发生率均低于对照组(均P<0.05)。两组患者术后的心率、血压变化及不良反应发生率比较,差异均无统计学意义(均P>0.05)。结论桡动脉穿刺前常规加用皮下注射硝酸甘油预防TRA、TRI术后桡动脉闭塞安全有效。Objective To explore the efficacy of conventional subcutaneous injection of nitroglycerin,additionally used before radial artery puncture,for the prevention of radial artery occlusion after transradial coronary angiography（ TRA）/transradial coronary intervention（ TRI）. Methods A total of 195 patients with TRA and TRI were selected and were randomly divided into observation group（ n = 99） and control group（ n = 96）. The observation group was given subcutaneous injection of 0. 5 ml normal saline containing 500 μg nitroglycerin before radial artery puncture,while the control group was given subcutaneous injection of 0. 5 ml normal saline before radial artery puncture. After operation,compression hemostasis using radial artery hemostat was performed in both groups,following radial artery sheath removal. After one day,three weeks and four months of operation,color Doppler ultrasonography and palpation of radial artery were conducted to observe the incidence of radial artery occlusion in affected side,as well as the changes of blood pressure and heart rate and the incidence of related adverse reactions of the patients. Results After three weeks and four months of operation,the incidence rates of radial artery occlusion in the observation group were lower than those in the control group（ all P 〈0. 05）. There was no significant difference in the postoperative heart rate,blood pressure or incidence rate of adverse reactions between the two groups（ all P 〉0. 05）. Conclusion Conventional subcutaneous injection of nitroglycerin,additionally used before radial artery puncture,is safe and effective in preventing radial artery occlusion after TRA or TRI.

关 键 词：桡动脉闭塞 硝酸甘油 经桡动脉冠状动脉造影 经桡动脉冠状动脉介入治疗 

分 类 号：R654.2[医药卫生—外科学]