桡动脉远端穿刺术相比桡动脉穿刺术的应用对比分析  

The Application Effects of Distal Radial Artery Puncture Compared with Radial Artery Puncture

作　　者：司晓云 李勇兵 李伟 蒋先文 候艳平 张姝 那荣妹 SI Xiao-yun;LI Yong-bing;LI Wei;JIANG Xian-wen;HOU Yan-ping;ZHANG Shu;NA Rong-mei(Department of Cardiology,Affiliated Hospital,Guizhou Medical University,Guizhou Guiyang 550004;Department of Cardiology,Panzhou People's Hospital,Guizhou Panzhou 561601)

机构地区：[1]贵州医科大学附属医院心血管内科,贵州贵阳550004 [2]盘州市人民医院心血内科,贵州盘州561601

出　　处：《中国医疗器械信息》2020年第18期25-27,共3页China Medical Device Information

基　　金：国家自然科学基金:81960047;贵州省科技计划:黔科合平台人才(2018)5608、黔科合支撑[2019]2800、黔科合基础[2019]1260;贵州省普通高等学校科技拔尖人才支持计划:黔教合KY字(2016)070;贵阳市科技计划:GY2017-34;临床医学PBL教学实践改革项目:2017007;心血管病理论与实践教学案例库项目:0711007020256。

摘　　要：目的:探讨桡动脉远端穿刺术相比桡动脉穿刺术的应用效果。方法:选取盘州市人民医院2019年10月~2019年12月择期行冠脉造影或行PCI术的患者为研究对象。其中56例选择桡动脉穿刺作为对照组,48例选择桡动脉远端穿刺术作为观察组。记录患者的基线特征等基本情况。对照组采用桡动脉穿刺部位穿刺,观察组采用桡动脉远端穿刺部位进行穿刺。记录各组穿刺所用时长,一次性穿刺成功率、总体成功率;记录穿刺时的生命体征。术后告知患者触摸脉搏的正确方法,每日进行穿刺部位脉搏记录,出院患者进行电话随访脉搏情况,持续至术后30d。结果:两组患者的一般资料情况、穿刺时间及穿刺时的生命体征无明显差异。观察组的一次性成功率高于对照组,而总体成功率低于对照组,均P<0.05。穿刺成功率相关因素分析提示,体重指数明显相关,P<0.05,与低体重指数相比,正常、肥胖、重度肥胖患者的OR分别为1.45、2.67、1.48。两组患者血管闭塞生存率结果提示,观察组的闭塞率明显低于对照组,具有统计学差异,P<0.05。结论:桡动脉远端穿刺术适用于体重指数正常或升高的患者,是桡动脉造瘘、瘢痕形成、双侧桡动脉手术入路患者的有效备选途径。Objective:To investigate the effects of distal radial artery puncture(DRAR)compared with radial artery puncture(RAR).Methods:Patients who underwent coronary angiography or PCI at the Panzhou People's Hospital from October 2019 to December 2019 were selected as the research objects.56 cases were selected as the control group,and 48 cases as the observation group.Recording the time for puncture,the single success rate of the puncture,and the overall success rate of each group;recording the vital signs at the time of puncture.The discharged patients were followed up on the pulse by telephone for 30 days after operation.Results:The one-time success rate of the observation group was higher than that of the control group,while the overall success rate was lower than that of the control group,both P<0.05.Analysis of factors related to puncture success rate showed that BMI was significantly related,P<0.05.Compared with low BMI,the ORs of normal,obese,and severely obese patients were 1.45,2.67,and 1.48,respectively.The occlusion rate in the observation group was significantly lower than that in the control group,with a statistical difference,P<0.05.Conclusion:The DRAR is suitable for patients with normal or elevated BMI.It is an effective alternative for patients with radial artery fistula,scar formation,and bilateral radial artery surgical approach.

关 键 词：桡动脉远端穿刺术 鼻烟壶区 

分 类 号：R459.7[医药卫生—急诊医学]