经dTRA、常规TRA穿刺置管在冠脉和脑血管“一站式”造影检查中的应用对比观察  

Comparison in application of catheterization through distal transradial approach and conventional transradial approach in one-stop coronary and cerebral angiography

作　　者：夏仙之 张施明[1] 吴映红 王颖颖 XIA Xianzhi;ZHANG Shiming;WU Yinghong;WANG Yingying(Cardiovascular Internal Medicine,The First Affiliated Hospital of Guangxi University of Science and Technology,Liuzhou 545000,China)

机构地区：[1]广西科技大学第一附属医院心血管内科,广西柳州545000

出　　处：《山东医药》2024年第21期19-23,共5页Shandong Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020007)。

摘　　要：目的对比观察经远端桡动脉入路(d TRA)、常规桡动脉入路(TRA)穿刺置管在冠脉和脑血管“一站式”造影检查中的应用效果。方法择期行冠脉和脑血管“一站式”造影检查的受检者49例,随机分为d TRA 24例、TRA组25例,d TRA受检者采用经d TRA穿刺置管进行冠脉和脑血管“一站式”造影检查,TRA组采用经TRA穿刺置管进行冠脉和脑血管“一站式”造影检查。观察并比较两组受检者穿刺置管成功率、穿刺置管时间、手术时间、X射线曝光时间、术中累计放射总量、造影剂用量、压迫止血时间、术后食指血氧饱和度、术后住院时间、术后第1天VAS评分、术后第3天VAS评分、住院患者满意度等手术相关资料,以及术后出现迷走神经反射、穿刺点出血、右手及前臂张力性血肿、桡神经损伤、桡动脉闭塞、桡动脉痉挛、皮肤溃烂等并发症发生情况。结果d TRA组受检者穿刺置管时间、住院患者满意度均高于TRA组,术后第1天VAS评分、术后第3天VAS评分、压迫止血时间均低于TRA组(P均<0.05)。两组受检者均未出现迷走神经反射、穿刺点出血、右手及前臂张力性血肿、桡神经损伤、桡动脉闭塞、桡动脉痉挛、皮肤溃烂等相关并发症。结论与经TRA穿刺置管进行冠脉和脑血管“一站式”造影检查相比,经d TRA穿刺置管进行冠脉和脑血管“一站式”造影检查术后疼痛减轻、压迫止血时间缩短,患者满意度更高,可作为冠脉和脑血管“一站式”造影检查的常规入路之一。Objective To compare and observe the application effects of catheterization through distal transradial approach(dTRA)and conventional transradial approach(TRA)in one-stop coronary and cerebral angiography.Methods Forty-nine participants who underwent selective one-stop coronary and cerebral angiography were randomly di‑vided into the dTRA group(n=24)and TRA group(n=25).Subjects in the dTRA group underwent"one-stop"coronary and cerebral angiography via catheterization through dTRA;while those in the TRA group received"one-stop"coronary and cerebral angiography via catheterization through TRA.Further observation and comparison were performed on the suc‑cess rate of catheterization,duration of catheterization,surgical time,X-ray exposure duration,cumulative intraoperative radiation dose,contrast agent dosage,duration of compression hemostasis,postoperative blood oxygen saturation on the in‑dex finger,postoperative length of stay in the hospital,VAS scores on postoperative day 1 and day 3,the degree of patient satisfaction and other surgical related data between the two groups as well as the occurrence of postoperative complications such as vasovagal reflex,bleeding at the puncture site,tension hematoma in the right hand and forearm,radial nerve inju‑ry,radial artery occlusion,radial artery spasm,and skin ulceration,etc.Results The duration of catheterization and the degree of patient satisfaction in the dTRA group were higher than those in the TRA group,while VAS scores on postop‑erative day 1 and day 3,and duration of compression hemostasis were lower than those in the TRA group(all P<0.05).Furthermore,subjects in both groups did not experience any complications such as vasovagal reflex,bleeding at the punc‑ture site,tension hematoma in the right hand and forearm,radial nerve injury,radial artery occlusion,radial artery spasm,skin ulceration,etc.Conclusions The"one-stop"coronary and cerebral angiography via catheterization through dTRA can alleviate postoperative pain,shorten the duration of compression

关 键 词：血管造影 冠状动脉造影 脑血管造影 动脉穿刺置管术 动脉穿刺置管入路 桡动脉 远端桡动脉 

分 类 号：R543.5[医药卫生—心血管疾病]