两种穿刺方法行选择性脑血管造影结果比较

Compared with two Approachs for selective Cerebral Angiography

目的:探讨经桡动脉穿刺和经股动脉穿刺选择性脑血管造影的安全性及有效性。方法:选择我院2002年5月～2008年10月收住153例行选择性脑血管造影患者,根据患者的桡动脉Allen试验选择经皮桡动脉穿刺78例及股动脉的搏动强弱选择经皮股动脉穿刺75例。术后对X线曝光时间(min)、造影剂量、手术操作时间(min)、血管并发症、术后24h内自理能力进行统计学分析。结果:术后随访1.5月。2组的年龄、X线曝光时间、手术操作时间P>0.05说明两者的差别无统计学意义。而血管并发症发生率P<0.05说明两者差别有统计学意义,经股动脉途径要高于桡动脉,桡动脉组术后24h内自理能力优于股动脉组。结论:经皮桡动脉穿刺选择性脑血管造影是一种安全、可靠,血管并发症少的手术方式,值得临床推广应用。

Objective：To assess the safety and success of the transradial approach and transfemoral approach for diagnostic cerebral arteriography.Methods：We reviewed the medical records of 153 cerebral angiographic studies were performed by use of a transradial and Transfemoral approach between May 2002 and October 2001. Before transradial procedure,we confirmed the collateral blood supply to the hand from the ulnar artery using a modified Allen test; Before transfemoral procedure,we confirmed impulse of femoral artery.after operations, we analysis X-ray exposure time（min ） ,constrast medium dose ,operative procedure time（ rain ）, angei-complications ,self-care ability in 24 hours after operations with statistics. Results：The mean time to initial clinical follow-up was 1.5 months.the difference of age, X-ray exposure time ,constrast medium dose ,operative procedure time is not statistically significant.However, transradial approach is better than transfemoral approach in angei-complications and self-care ability in 24 hours.Conclusion：Compared with transfemoral and transbrachial approaches, transradial approach for selective Cerebral Angiography is safety ,efficacy and less invasive for selective cerebral angiography and may warrant consideration as a standard procedure.