经桡动脉途径普通J型导丝与超滑导丝的临床应用

Clinical applications of normal J-type guidewire and supersmooth guidewire during transradial coronary angiography

目的观察经桡动脉途径进行冠状动脉造影时,普通J型导丝与亲水涂层超滑导丝的临床效果。方法将120例行冠状动脉造影检查的患者随机平均分入超滑组(n=60)与普通组(n=60),超滑组患者使用亲水涂层超滑导丝,普通组患者使用普通J型导丝,对两组患者不适感觉、术者操作手感、导丝通过时间、导丝失败例数、并发症出现例数进行比较分析。结果①普通组与超滑组比较,患者均无明显不适感,超滑组有5例患者出现轻度不适,但两组差异无统计学意义(P>0.05);②术者对普通组52名患者进行操作时感到轻度阻力,超滑组仅4例感到有轻度阻力,两组差异有统计学意义(P<0.01);③普通组导丝通过时间短于超滑组,差异无统计学意义(P>0.05);④超滑组导丝通过失败0例,普通组导丝通过失败2例;⑤并发症:超滑组发生桡动脉痉挛2例,前壁张力性血肿2例;普通组发生桡动脉痉挛2例,差异无统计学意义(P>0.05)。结论经桡动脉途径进行冠状动脉造影时,使用普通J型导丝简便易行,与超滑导丝的临床效相当且性价比较高,患者更易接受。

Objective To observe the clinical effects of normal J-type guidewire and supersmooth guidewire with hydrophilic coating during transradial coronary angiography （ TCAG ） . Methods The patients （ n =120 ） having TCAG were randomly divided into supersmooth group and normal group. The supersmooth group was given supersmooth guidewire with hydrophilic coating and normal group was given normal J-type guidewire. The discomfort feeling of the patients, hand feels of operators, pass time of guidewire, fail cases and cases with complications were compared and analyzed in two groups. Results ① The patients in normal group had no obvious discomfort feeling and there were 5 cases with mild discomfort feeling in supersmooth group, but the difference was not statistically significant. ② The operators had mild ressitance during TCAG in 52 patients in normal group, and only 4 in supersmooth group （ P 0.01 ） . ③ The pass time of guidewire was shorter in normal group than that in supersmooth group, but the difference was not statistically significant （ P 0.05 ） . ④ TCAG was failed in 0 case in supersmooth group and 2 in normal group. ⑤ The complications included radial artery spasm in 2 cases and anterior tension hematoma in 2 cases in supersmooth group, and radial artery spasm in 2 cases in normal group, but the difference was not statistically significant. Conclusion During TCAG, normal J-type guidewire is simple and easy to operate, which has the same clinical effect as supersmooth guidewire and higher effect-cost ratio, and is more acceptable by patients.