经桡动脉和股动脉路径行全脑血管造影和颈动脉支架置入术患者辐射剂量及照射时间研究  

Radiation dose and irradiation time in patients undergoing whole cerebral angiography and carotid artery stenting via radial and femoral artery routes

作　　者：张紫寅 王德全[1] 段彬[2] 雷震 龙强友 漆新伟[1] 张昌伟[3] Zhang Ziyin;Wang Dequan;Duan Bin;Lei Zhen;Long Qiangyou;Qi Xinwei;Zhang Changwei(Department of Neurosurgery,the Seventh People's Hospital of Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第七人民医院神经外科,四川610041 [2]成都市第七人民医院介入科,四川610041 [3]四川大学华西医院神经外科

出　　处：《脑与神经疾病杂志》2020年第4期203-207,共5页Journal of Brain and Nervous Diseases

基　　金：四川省科技支撑项目(2016FZ0073)。

摘　　要：目的对比经桡动脉和股动脉路径行脑数字减影血管造影术(DSA)和颈动脉支架置入术患者辐射剂量及照射时间。方法分析2012年1月至2018年9月在四川大学华西医院和成都市第七人民医院行DSA与DSA+颈动脉支架置入术(CAS)的213例患者,其中行DSA患者147例,DSA+CAS者66例。术前先对患者行Allen‘s试验,桡动脉搏动良好且试验阳性经患者同意行桡动脉穿刺者为观察组,其余行股动脉穿刺者为对照组。行DSA患者中对照组52例,观察组95例。行DSA+CAS患者中对照组24例,观察组42例。对照组行股动脉穿刺,观察组行桡动脉穿刺。分别对比不同介入方式的DSA与DSA+CAS患者累积剂量(CD)、总剂量面积乘积(DAP)、电影(DAP)、透视(DAP)、透视时间及采集帧数、射线照射时间及术后并发症。结果两组DSA患者射线照射时间及假性动脉瘤对比差异无统计学意义(P>0.05),观察组患者血肿及尿潴留发生率均明显低于对照组(P>0.05)。两组DSA+CAS患者假性动脉瘤发生率对比差异无统计学意义(P>0.05),观察组射线照射时间、血肿及尿潴留发生率均明显低于对照组(P<0.05)。两组DSA患者CD、总剂量DAP、电影DAP、透视DAP及采集帧数对比差异无统计学意义(P>0.05),DSA+CAS患者中观察组患者CD、总剂量DAP、电影DAP、透视DAP及采集帧数均明显较对照组小(P<0.05)。结论经桡动脉和股动脉路径相比行全脑血管造影对辐射剂量及照射时间均无显著影响,但经桡动脉可明显降低术后并发症发生率。经桡动脉行颈动脉支架置入术较股动脉路径可明显降低辐射剂量,缩短照射时间,降低并发症发生率。Objective To compare the radiation dose and irradiation time of patients undergoing cerebral angiography and carotid artery stenting via radial artery and femoral artery.Methods Analyze a total of 213 patients with digital subtraction angiography(DSA)and DSA+carotid angioplasty and stenting(CAS)who were enrolled in the West China Hospital of Sichuan University and the Seventh People's Hospital of Chengdu from January 2012 to September 2018.A retrospective analysis was performed in which 147 patients were treated with DSA and 66 patients with DSA+CAS.Allen's test was performed on the patient before operation.The brachial artery pulsation was good and the test was positive.The patient agreed to take the radial artery puncture as the observation group,and the other femoral artery puncture was the control group.Among the DSA patients,52 were in the control group and 95 in the observation group.Among the DSA+CAS patients,24 were in the control group and 42 in the observation group.The control group underwent femoral artery puncture and the observation group underwent radial artery puncture.cumulativc dose(CD),dose area product(DAP),movie DAP,fluoroscopy DAP,fluoroscopy DAP,fluoroscopy Time and Frame Number,Radiation Time and Postoperative Complications were compared between DSA and DSA+CAS patients with different interventional methods.Results There was no significant difference in radiation exposure time and pseudoaneurysm between the two groups(P>0.05).The incidence of hematoma and urinary retention was significantly lower in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of pseudoaneurysm between the two groups(P>0.05).The incidence of radiation exposure,hematoma and urinary retention were significantly lower in the observation group than in the control group(P<0.05).There was no significant difference in CD,total dose DAP,film DAP,fluoroscopy DAP and collection frame between the two groups of DSA patients(P>0.05).CD,total dose DAP,movie DAP,perspective

关 键 词：桡动脉 股动脉 数字减影血管造影术 颈内动脉支架置入术 

分 类 号：R743.32[医药卫生—神经病学与精神病学]