经桡动脉不同穿刺点行冠状动脉介入术的临床效果  

Clinical Efficacy of Different Transradial Puncture Sites in Coronary Intervention Procedures

作　　者：谢立新 李桂娇 XIE Lixin;LI Guijiao(Nanning Third People's Hospital,Nanning 530003,China)

机构地区：[1]南宁市第三人民医院,广西南宁530003

出　　处：《延边大学医学学报》2025年第2期26-28,共3页Journal of Medical Science Yanbian University

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-A20221200)。

摘　　要：目的:观察经桡动脉不同穿刺点行冠状动脉介入术的临床效果。方法:将符合入选标准的300例经桡动脉行冠状动脉介入术的患者随机分为三组,A组选择距离第一腕横纹桡侧1.5 cm处为穿刺点;B组选择距离第一腕横纹桡侧3.0 cm处为穿刺点;C组选择距离第一腕横纹桡侧4.5 cm处为穿刺点。观察三组的桡动脉穿刺成功率、导丝置入成功率、动脉鞘管置管成功率及术口出血、术侧肢体疼痛、肿胀、皮肤损伤、桡动脉闭塞等并发症的发生情况。结果:B组和C组的桡动脉穿刺成功率均高于A组(P <0.05)。B组和C组的导丝置入成功率均高于A组(P <0.05)。三组的动脉鞘管置管成功率均为100%。三组术后并发症发生率对比,A组在术口出血、术侧肢体疼痛、术侧肢体肿胀和桡动脉闭塞方面的发生率均高于B组和C组(P <0.05);而皮肤损伤的发生率对比,差异无统计学意义(P> 0.05)。结论:在距离第一腕横纹桡侧3.0 cm和4.5 cm处经桡动脉穿刺行冠状动脉介入术可提高穿刺成功率和导丝置入成功率,降低术后并发症发生率,具有较好的临床应用效果。Objective:To evaluate the clinical efficacy of coronary intervention procedures performed via different transradial puncture sites.Methods:A total of 300 patients undergoing transradial coronary intervention were randomized into three groups:GroupA:Puncture site at 1.5 cm proximal to the first radial wrist crease.Group B:Puncture site at 3.0 cm proximal to the first radial wrist crease.Group C:Puncture site at 4.5 cm proximal to the first radial wrist crease.Outcomes included radial artery puncture success rate,guidewire insertion success rate,arterial sheath cannulation success rate,and postoperative complications(incision bleeding,limb pain,limb swelling,skin injury,radial artery occlusion).Results:Radial artery puncture success rates in Groups B and C were significantly higher than in Group A(P<0.05).Guidewire insertion success rates in Groups B and C were also higher than in Group A(P<0.05).Arterial sheath cannulation success rate was 100%in all groups.Postoperative complications:Group A exhibited significantly higher incidences of incision bleeding,limb pain,limb swelling,and radial artery occlusion compared to Groups B and C(P<0.05),while no significant difference in skin injury incidence was observed(P>0.05).Conclusion:Transradial coronary intervention performed at puncture sites 3.0 cm and 4.5 cm proximal to the first radial wrist crease improves procedural success rates and reduces postoperative complications,demonstrating superior clinical applicability.

关 键 词：冠状动脉介入术 经桡动脉穿刺 穿刺点 

分 类 号：R541.4[医药卫生—心血管疾病]