双超滑导丝在冠脉介入治疗并发桡动脉痉挛时的应用价值  

Application Value of Double Super-sliding Guide Wire in Coronary Interventional Treatment with Radial Artery Spasm

作　　者：张施明[1] 吴西林[1] 黄德堂 Zhang Shiming;Wu Xilin;Huang Detang(The First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou,Guangxi 545002,China)

机构地区：[1]广西科技大学第一附属医院,广西柳州545002

出　　处：《四川医学》2020年第9期907-912,共6页Sichuan Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2017006)。

摘　　要：目的探讨经皮冠状动脉介入治疗(PCI)并发桡动脉严重痉挛时,应用双超滑导丝辅助通过技术(DGWAT)通过痉挛段血管的安全性和可行性。方法分析2016年1月至2019年11月我院经桡动脉路径PCI伴有严重桡动脉痉挛的患者50例。按照随机数字表法抽取一种处理策略,抽中采用双超滑导丝辅助通过技术的26例患者为DGWAT组,抽中采用球囊辅助通过技术(BAT)的24例患者为BAT组。观察两种技术指引导管通过桡动脉痉挛段的时间、成功率,以及并发症的发生率等指标,比较两种技术的优劣。结果DGWAT组较BAT组指引导管通过时间明显缩短[(2.51±1.10)min vs.(4.18±1.38)min,P<0.0001],差异有统计学意义,提示DGWAT组效率更高。DGWAT组指引导管通过率稍高于BAT组[26例(100%)vs.22例(91.6%),P=0.133],差异无统计学意义。DGWAT组较BAT组前臂血肿发生率稍低[1例(3.85%)vs.2例(8.33%),P=0.504],差异无统计学意义。结论经皮冠状动脉介入治疗(PCI)并发桡动脉严重痉挛时,应用DGWAT技术可快速、安全有效地使指引导管跨越桡动脉痉挛段,较BAT技术效率更高。Objective To explore the safety and feasibility of using double guide wire assisted tracking(DGWAT)to pass the spasm vessel when percutaneous coronary intervention(PCI)complicated with severe radial artery spasm.Methods From January 2016 to November 2019 in our hospital,a total of 50 patients who had PCI through radial artery associated with severe radial artery spasm were analyzed.According to a random number table method,26 patients who used DGWAT were selected as test group(TG),and 24 patients who used balloon assisted tracking(BAT)were selected as control group(CG).The time,success rate,incidence of complications and other indicators of two techniques to guide catheter through radial artery spasm segment were observed.The pros and cons of two techniques were compared.Results TG was significantly shorter than CG in guiding catheter passage time with statistically significant difference[(2.51±1.10)min vs.(4.18±1.38)min,P<0.0001],suggesting high efficiency of TG.The guide catheter passing rate in TG was slightly higher than that in CG[26 cases(100%)vs.22 cases(91.6%),P=0.133].The incidence of forearm hematoma in TG was slightly lower than that in CG[1 case(3.85%)vs.2 cases(8.33%),P=0.504].Conclusion When PCI complicated with severe radial artery spasm,DGWAT technology could quickly,safely and effectively make guiding catheter across the radial artery spasm,which is more efficient than BAT technology.

关 键 词：双超滑导丝 冠脉介入治疗 桡动脉痉挛 

分 类 号：R541.4[医药卫生—心血管疾病]