头端压弯泥鳅导丝与头端J型聚四氟乙烯涂层导丝在经桡动脉冠状动脉造影中应用效果比较  

Application comparison between loach guide wire with bent head end and polytetrafluoroethylene-coated guide wire with Jshaped head end in transradial coronary angiography

作　　者：李振威 徐庆青 皇甫宁 崔翰斌[1] LI Zhenwei;XU Qingqing;HUANGFU Ning;CUI Hanbin(Department of Cardiology,the First Affiliated Hospital of Ningbo University,Ningbo 315000,China;不详)

机构地区：[1]宁波大学附属第一医院心内科,315000 [2]宁波大学附属第一医院肾内科,315000

出　　处：《浙江医学》2024年第22期2405-2409,共5页Zhejiang Medical Journal

基　　金：浙江省中医药科技计划项目(2024ZL146);宁波市重点研发计划项目(2022Z149);浙江省省级重点实验室认定名单项目(2022E10026)。

摘　　要：目的探讨头端压弯泥鳅导丝与头端J型聚四氟乙烯(PTFE)涂层导丝在经桡动脉途径冠状动脉造影(CAG)中的有效性和安全性。方法回顾性选择2022年4月至2023年4月在宁波大学附属第一医院诊断为可疑冠心病的患者1695例,其中在CAG术中首次使用头端压弯泥鳅导丝患者714例(观察组),头端J型PTFE涂层导丝患者981例(对照组),收集并比较两组患者的基本数据、导丝血管通过率、手术时间、射线时间、射线剂量、对比剂用量、更换导丝比例、更换左侧桡动脉比例、更换造影导管比例及手术并发症。采用多因素logistic回归分析导丝血管通过率的影响因素。结果观察组导丝血管通过率明显高于对照组(98.9%比93.5%),差异有统计学意义(P<0.05),对照组通过将导丝更换为头端压弯泥鳅导丝后导丝血管通过率升高至98.5%(966/981);观察组手术时间、射线时间、射线剂量、对比剂用量、更换导丝比例、血管痉挛发生率、迷走神经反射发生率均低于对照组,差异均有统计学意义(均P<0.05)。两组患者血管夹层、前臂血肿、更换造影导管和更换左侧桡动脉比例比较,差异均无统计学意义(均P>0.05)。两组患者均无血管穿孔、纵隔血肿发生。多因素logistic回归分析结果发现年龄及首次使用头端压弯泥鳅导丝均是导丝血管通过率的影响因素(均P<0.05)。结论头端压弯泥鳅导丝相对头端J型PTFE涂层导丝在经桡动脉入路CAG术中更有效且安全,值得临床推广应用。Objective To evaluate and compare the effectiveness and safety of loach guide wire with bent head end and polytetrafluoroethylene(PTFE)-coated guide wire with J-shaped head end in coronary angiography(CAG)via the radial artery.Methods The study retrospectively selected 1695 patients with suspected coronary heart disease diagnosed at the First Affiliated Hospital of Ningbo University from April 2022 to April 2023.According to the guide wire type that patients used at the first time during CAG,patients were divided into a loach guidewire group with bent head(observation group,n=714)and a PTFE-coated guide wire group with J-shaped head end(control group,n=981).Patients in the two groups were compared in basic data,guide wire vascular passage rate,surgical time,radiation time,radiation dose,contrast dose,guide wire replacement ratio,left radial artery replacement ratio,contrast catheter replacement ratio,and surgical complications.The factors influencing the guide wire vessel passage rate were analyzed by multivariate logistic regression.Results The vascular passage rate of the observation group was higher than that of the control group(98.5%vs.93.5%,P<0.05).The control group increased the vascular passage rate of the guide wire to 98.5%(966/981)by replacing the guide wire with a head-end bent loach guide wire.The observation group experienced shorter surgical time and radiation time,and lower radiation dose,contrast dose,wire replacement ratio,incidence of vascular spasm,and incidence of vagus reaction than the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the proportion of vascular dissection,forearm hematoma,replacement of contrast catheter,and replacement of left radial artery between the two groups of patients(all P>0.05).Neither group of patients experienced vascular perforation or mediastinal hematoma.The results of multivariate logistic regression analysis revealed that both age and the first-time use of the loach guide wire w

关 键 词：泥鳅导丝 聚四氟乙烯涂层导丝 桡动脉 冠脉造影 血管路径 

分 类 号：R541.4[医药卫生—心血管疾病]