双超滑导丝在急性心肌梗死患者经桡动脉路径行经皮冠状动脉介入治疗时并发桡动脉痉挛中的应用效果  

Efficacy of double superglide wire applied to transradial percutaneous coronary intervention for treatment of acute myocardial infarction patients complicated with radial artery spasm

作　　者：张施明[1] ZHANG Shi-ming(Department of Cardiovascular Medicine,the First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou 545002,China)

机构地区：[1]广西科技大学第一附属医院心血管内科,柳州市545002

出　　处：《广西医学》2020年第11期1340-1344,共5页Guangxi Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2017006)。

摘　　要：目的探讨双超滑导丝在急性心肌梗死患者经桡动脉路径行经皮冠状动脉介入(PCI)治疗时并发桡动脉痉挛中的应用效果。方法将经桡动脉路径行PCI治疗时并发桡动脉痉挛的70例急性心肌梗死患者,根据随机数字表法分为研究组(n=36)和对照组(n=34)。研究组采用双超滑导丝辅助跨越桡动脉痉挛段,对照组采用常规药物方法处理桡动脉痉挛。比较两组桡动脉痉挛程度及长度,单侧桡动脉完成手术情况,成功通过痉挛血管段所需时间、到达导管室至梗死血管开通时间,以及局部血管并发症发生情况。结果两组患者桡动脉痉挛程度及长度差异均无统计学意义(均P>0.05)。研究组通过单侧桡动脉完成手术率高于对照组,成功通过痉挛血管段所需时间、到达导管室至梗死血管开通时间均短于对照组,而局部血管并发症率低于对照组(均P<0.05)。结论急性心肌梗死患者经桡动脉路径行PCI中并发桡动脉痉挛时应用双超滑导丝辅助可快速、安全有效地使指引导管跨越痉挛段,较常规应用抗痉挛药物方法更为安全、有效。Objective To explore the efficacy of double superglide wire applied to transradial percutaneous coronary intervention(PCI)for the treatment of acute myocardial infarction(AMI)patients complicated with radial artery spasm.Methods Seventy AMI patients complicated with radial artery spasm during transradial PCI were divided into study group(n=36)and control group(n=34)according to the random number table method.Traversing the spastic segment of the radial artery assisted by double superglide wire was performed in the study group,while routine medication for radial artery spasm management was performed in the control group.The related indices were compared between the two groups,including degree and length of radial artery spasm,accomplishment of unilateral radial artery surgery,duration for successfully traversing the spastic segment,duration between arrival at the catheter room and patency of infarcted artery,as well as incidence of local vascular complications.Results There was no statistically significant difference in degree or length of radial artery spasm between the two groups(all P>0.05).By comparison with the control group,the study group obtained higher accomplishment rate of unilateral radial artery surgery,shorter duration for successfully traversing the spastic segment,shorter duration between arrival at the catheter room and patency of infarcted artery,as well as lower incidence rate of local vascular complications(all P<0.05).Conclusion For AMI patients complicated with radial artery spasm during transradial PCI,auxiliary application of double superglide wire can quickly,safely and effectively guide the catheter through the spastic segment,which is safer and more effective than the conventional use of antispasmodics.

关 键 词：急性心肌梗死 经皮冠状动脉介入 桡动脉路径 桡动脉痉挛 双超滑导丝 

分 类 号：R542.22[医药卫生—心血管疾病]