老年患者经桡动脉途径冠状动脉介入术后上肢功能障碍的影响因素分析  

Analysis of influencing factors for upper limb dysfunction in elderly patients after transradial percutaneous coronary procedures

作　　者：王琳 陈佳佳 吴昱章 魏雅丽 唐琦 张宣仪 Wang Lin;Chen Jiajia;Wu Yuzhang;Wei Yali;Tang Qi;Zhang Xuanyi(Central Hospital of Jing'an District(Jing'an Branch of Huashan Hospital Affiliated to Fudan University),Shanghai,200040,P.R.China)

机构地区：[1]上海市静安区中心医院(复旦大学附属华山医院静安分院),上海200040

出　　处：《老年医学与保健》2024年第3期819-822,829,共5页Geriatrics & Health Care

基　　金：复旦大学—复星护理科研基金(FNF202046)。

摘　　要：目的评估经桡动脉进行冠状动脉介入操作(Transradial percutaneous coronary procedures,TR-PCP)导致上肢功能障碍的危险因素。方法入选2018年11月—2021年12月于静安区中心医院首次TR-PCP的患者,收集基线临床信息、TR-PCP术中和术后相关资料,采用快速手臂、肩部和手部残疾(快速DASH)问卷量表在出院前评价上肢功能情况,应用Logistic回归分析上肢功能障碍的影响因素。结果共计入选408例患者,其中19(4.7%)例出院前快速DASH评分>0分,平均(12.1±8.2)分(2.3~47.7)。单因素和多因素Logistic回归分析显示,年龄增加(OR 1.19,95%CI 1.07~1.33)、术后桡动脉压迫时长大于12 h(OR 8.12,95%CI 2.30~28.07)、应用辅助压迫装置(OR 7.84,95%CI 1.76~34.80)为导致术后短期出现上肢功能障碍的危险因素。结论TR-PCP引发上肢功能障碍对患者生活质量存在一定影响,多见于老年、术后桡动脉压迫时间长、应用辅助压迫装置的患者。Objective To evaluate the risk factors for upper limb dysfunction caused by transradial percutaneous coronary procedures(TR-PCP).Methods Patients who underwent TR-PCP for the first time in Central Hospital of Jing'an District from November 2018 to December 2021 were selected.Their baseline clinical information,intraoperative and postoperative data of TR-PCP were collected.The upper limb function of patients was assessed by the Quick Arm,Shoulder and Hand Disability(DASH)Questionnaire before discharge.Logistic regression was used to analyze the influencing factors for upper limb dysfunction.Results A total of 408 patients were included.Among them,19(4.7%)cases had a Quick DASH score>0 before discharge,with an average of(12.1±8.2)points(2.3-47.7).Univariate and multivariate logistic regression analysis showed that increased age(OR 1.19,95%CI 1.07-1.33),postoperative radial artery compression longer than 12 h(OR 8.12,95%CI 2.30-28.07),application of auxiliary compression devices(OR 7.84,95%CI 1.76-34.80)were risk factors for short-term upper limb dysfunction after surgery.Conclusion The upper extremity dysfunction caused by TR-PCP has a certain impact on the quality of life of patients,which is more common in the elderly patients with long-term postoperative radial artery compression and auxiliary compression devices.

关 键 词：老年 经桡动脉进行冠状动脉介入操作 并发症 上肢功能障碍 快速DASH问卷 

分 类 号：R541.4[医药卫生—心血管疾病]