Allen试验阴性患者经肱动脉和股动脉冠状动脉造影的对比研究

Comparison of transbrachial and transfemoral approach in patients with negative Allen's test result during coronary angiography

目的探讨经肱动脉和股动脉途径冠脉造影的优缺点。方法选择我院行冠脉造影的患者60例,均为Allen试验阴性患者,随机分为肱动脉组和股动脉组,每组30例,比较两组的穿刺成功率、造影成功率、手术操作时间、曝光时间、术后压迫时间及术后并发症。结果与股动脉组比较,肱动脉组术后平均压迫时间明显减少,差异有统计学意义(P<0.01),且患者无需卧床。而两组在穿刺成功率、造影成功率、手术操作时间、曝光时间等方面差异无统计学意义(P均>0.05)。结论对于Allen试验阴性不能经桡动脉穿刺的患者,包括桡动脉痉挛或闭塞的患者,经肱动脉行冠状动脉造影是安全可靠的替代方法,避免了股动脉穿刺后长时间卧床。

Objective To explore advantages and disadvantages of transrbrachial approach and transfemoral approach in patients with negative Allen＇s test during coronary angiography.Methods A total of 60 cases who would receive coronary angiography and had negative Allen＇s test result in our hospital from January 2011 to Oct 2011 were randomly divided into brachial group（n=30） and femoral group（n=30）.The artery puncture success rate,coronary angiography success rate,operation time,fluoroscopy time and incidence of post-operation complications were compared respectively and analyzed statistically.Results There was significant statistic difference in brachial group for shorter compression time（P〈0.01） and no need for patients stay in bed.However,there were no statistically significant difference between two groups in artery puncture success rate,coronary angiography success rate and opration time（P〉0.05）.Conclusion For patient with negative Allen＇s test result,both for spasm or occlusion in radial artery,transbrachial artery access approach is a safe and reliable substitute to avoid long time stay in bed.