前臂动脉超声联合超声显影线定位法指导经桡动脉介入治疗老年女性不稳定型心绞痛  

Forearm artery ultrasound combined with ultrasound imaging line positioning method to guide transradial artery interventional treatment of unstable angina pectoris in elderly women

作　　者：曹万才 曹洪垒 米加 董兆强[4] 周国 高东学 Cao Wancai;Cao Honglei;Mi Jia;Dong Zaoqiang;Zou Guo;Gao Dongxue(Department of Cardiology,Shandong Provincial Third Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250031,China;不详)

机构地区：[1]山东省立第三医院心血管内科,济南250031 [2]山东省济宁市第一人民医院心血管内科,济宁272011 [3]山东省立第三医院超声室,济南250031 [4]山东大学第二附属医院心血管内科,济南250033

出　　处：《中国循证心血管医学杂志》2021年第11期1356-1359,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨联合应用前臂动脉多普勒超声检查及桡动脉超声显影线定位法指导经桡动脉路径行冠状动脉介入(TRI)治疗老年女性不稳定型心绞痛(UAP)患者的有效性与安全性。方法选取山东省3家三级甲等医院心内科择期实施TRI的老年女性UAP住院患者,用随机数表法分为超声组与对照组两组。超声组在TRI前采用前臂动脉超声检查,桡动脉穿刺采用超声显影线定位法指导;对照组即传统触摸定位法操作,TRI前不行前臂动脉超声检查。观察两组桡动脉置管成功率、血管入路解剖变异、冠状动脉(冠脉)病变情况、操作总时间、手术总成功率、X线透视时间、对比剂总量及并发症等指标。结果共1246例患者入选,每组623例。两组患者年龄、易患因素及冠脉病变情况等资料,无统计学差异(P>0.05)。超声组与对照组的桡动脉置管成功率、手术总成功率与总并发症发生率依次为99.2%(618/623)vs.95.0%(592/623),98.2%(612/623)vs.92.9%(579/623),6.7%(42/623)vs.11.4%(71/623),差异均有统计学意义(P<0.01)。超声组与对照组的操作总时间、X线透视时间与前臂血肿发生率依次为(65.3±8.9)min vs.(76.8±7.3)min,(16.6±8.9)min vs.(17.4±8.3)min,5.8%(36/623)vs.8.9%(55/623),差异均有统计学意义(P<0.05)。超声组与对照组桡动脉解剖变异发生率、对比剂总量依次为16.8%(105/623)vs.15.6%(97/623),(139.3±55.4)ml vs.(146.8±42.9)ml,无统计学差异(P>0.05)。两组均无死亡病例。结论对于老年女性UAP患者,联合应用前臂动脉超声检查与桡动脉超声显影定位法指导下的TRI,有益于提高手术成功率和相对安全性。Objective To explore the effectiveness and safety of combined application of forearm artery Doppler ultrasonography and radial artery ultrasound imaging line positioning method to guide coronary intervention(TRI)via radial artery in the treatment of elderly women with unstable angina pectoris(UAP).Methods Elderly female UAP inpatients who electively implemented TRI in the cardiology department of 3 tertiary A hospitals in Shandong Province were selected and divided into two groups:ultrasound group and control group by random number table method.The ultrasound group used forearm artery ultrasound examination before TRI,and the radial artery puncture was guided by ultrasound imaging line positioning method;the control group was operated by traditional touch positioning method,and forearm artery ultrasound examination was not performed before TRI.The success rate of the radial artery catheterization,the anatomical variation of the vascular approach,the condition of coronary artery disease,the total operation time,the total success rate of the operation,the X-ray fluoroscopy time,the total amount of contrast agent,and complications were observed in the two groups.Results A total of 1246 patients were enrolled,623 cases in each group.There was no statistical difference in the age,susceptibility factors and coronary artery disease between the two groups(P>0.05).The success rate of radial artery catheterization,total surgical success rate and total complication rate of the ultrasound group and the control group were 99.2%(618/623)vs.95.0%(592/623),98.2%(612/623)vs.92.9%(579/623),6.7%(42/623)vs.11.4%(71/623),the difference was statistically significant(P<0.01).The total operating time,X-ray fluoroscopy time and incidence of forearm hematoma in the ultrasound group and the control group were(65.3±8.9)min vs.(76.8±7.3)min,(16.6±8.9)min vs.(17.4±8.3)min,5.8%(36/623)vs.8.9%(55/623),the difference was statistically significant(P<0.05).The incidence of anatomical variation of the radial artery and the total amount of contr

关 键 词：经皮冠脉介入治疗 经桡动脉路径介入治疗 超声检查 显影线定位 女性 

分 类 号：R541.4[医药卫生—心血管疾病]