两种远端桡动脉通路在冠状动脉造影及介入治疗中的可行性及安全性  

Comparison of the feasibility and safety of two distal radial artery pathways in coronary angiography and interventional therapy

作　　者：李岩[1] 李林[1] 鲁广见 许娜 LI Yan;LI Lin;LU Guangjian;XU Na(Department of Cardiovascular Medicine,Jining No.1 People′s Hospital,Jining 272000,China)

机构地区：[1]济宁市第一人民医院心内科,济宁272000

出　　处：《济宁医学院学报》2023年第5期324-327,共4页Journal of Jining Medical University

摘　　要：目的对两种远端桡动脉通路在冠状动脉造影及介入治疗中的可行性及安全性进行比较,以期为临床工作提供参考依据。方法选取2022年2月至2022年5月于济宁市第一人民医院行冠状动脉造影(coronary angiography,CAG)及介入治疗的患者445例,采用随机数字表法分为合谷穴组220例和解剖鼻烟窝(anatomical snuffbox,AS)组225例,比较两组的穿刺情况、手术完成率及并发症发生率。结果两组在穿刺成功率、穿刺时间、手术完成率、桡动脉痉挛、出血、水肿等方面差异均无统计学意义(P>0.05);合谷穴组桡神经损伤发生率低于AS组(0%vs 3.1%,P<0.05),疼痛数字评分(numeric rating scale,NR)合谷穴组高于AS组(2.21±1.33 vs 1.93±1.36,P<0.05)。结论相较AS内桡动脉穿刺,合谷穴内桡动脉穿刺可降低术后桡神经损伤发生率,具有更高的安全性,但疼痛增加降低了患者的舒适度。Objective To compare the feasibility and safety of two distal radial artery pathways in coronary angiography and interventional therapy,hoping to provide reference for clinical work.Methods A total of 445 patients who underwent coronary angiography and interventional therapy in Jining No.1 People′s Hospital from February 2022 to May 2022 were randomly divided into Hegu acupoint group(220 cases)and anatomical snuffbox group(225 cases).The puncture situation,operation completion rate and incidence of complications were compared between the two groups.Results There was no statistical significance difference between two groups in the rate of successful puncture,puncturetime,operation completion rate,radical artery spasm,bleeding and edema(P>0.05).The incidence of radial nerve injury in the Hegu acupoint group was significantly lower than that in the AS group(0%vs 3.1%,P<0.05).The NR score in the Hegu acupoint group was significantly higher than that in the AS group(2.21±1.33 vs 1.93±1.36,P<0.05).Conclusion Compared with radial artery puncture in AS,radial artery puncture at the Hegu acupoint can reduce the incidence of postoperative radial nerve injury and has higher safety,but the significant increase in NR score reduces the patient comfort.

关 键 词：远端桡动脉 冠状动脉介入 并发症 桡神经损伤 疼痛评分 

分 类 号：R814.43[医药卫生—影像医学与核医学]