经桡动脉介入治疗局部应用维拉帕米防治桡动脉痉挛的有效性及安全性临床观察

Efficacy and safety of verapamil during trans-radial approach intervention procedure

目的:观察经桡动脉路径介入治疗时局部应用维拉帕米防治桡动脉痉挛的有效性及安全性。方法:80例经桡动脉路径介入治疗的患者,成功置入鞘管后注入维拉帕米5 m g,记录维拉帕米注入前、注入后2,5,10,30 m in患者心率、血压、局部及全身情况变化。结果:80例患者均未发生桡动脉痉挛,均未发现心力衰竭和传导阻滞加重,均于维拉帕米注入后出现上肢烧灼和胀麻感,但很快消失(<30 s)。维拉帕米注入前、后心率及舒张压的差异均无显著性(P>0.05);注入前、后收缩压的差异有显著性(P<0.05),但注入后不同时间点组间差异无显著性(P>0.05)。结论:经桡动脉介入治疗时,局部应用维拉帕米可以有效防治桡动脉痉挛的发生,并且对心率、传导、舒张压和心功能无明显影响。

Objective To observe the efficacy and safety of verapamil when injected into the radial artery in order to avoid radial artery spasm during the transradial approach intervention for coronary angiography and angioplasty. Methods Eighty patients who had arranged to angiography or angioplasty by the transradial approach were admitted. Verapamil was injected into the radial artery after radial artery vasosheath was planted successfully. The heart rate and the blood pressure were recorded at different time interval. Furthermore, general condition was observed after verapamil was injected. Results The radial artery spasm didn＇t not happen in all of the patients. The heart function and general conduction did not get worse. But the patients all had a hot flush feeling in their hands and arms, which last for very short time （〈30 s）. The variance of heart rate and DBP did not show statistical notability （P〉0. 05）. The variance of SBP had shown statistical notability between preinjection and post-injection （P〈0. 05）, however, the variance of SBP did not show statistical notability at different time interval after the verapamil was injected（P〉0.05）. Conclusion During the trans-radial approach intervention for coronary angiography and angioplasty, 5 mg verapamil can avoid radial artery spasm effectively and has no effect on patient＇s heart rate, DBP and heart function.