股动脉穿刺部位选择对术后并发症的影响

Effect of Puncturing Site at Femoral Artery on Postoperative Complications

目的研究和评价股动脉穿刺位置的高低对术后并发症的影响。方法选择无高血压拟单纯行冠状动脉造影的患者，术前仅服用拜阿斯匹林，共317例，随机分为3组，采用Seldinger’s技术，进行股动脉高位、中位、或低位穿刺（血管穿刺内口至腹股沟韧带距离分别为0．1～1．5cm、1．6～2．5cm、〉2．5cm），穿刺后测量证实穿刺位置，分析穿刺位置对术后并发症的影响。结果与股动脉高位穿刺相比，中位和低位穿刺显著增加术后并发症的发生率（P〈0．05），随年龄增加并发症发生率增加。操作手法正确时，术中穿刺次数增加并不显著增加血管并发症的发生率。结论股动脉穿刺的位置过低和年龄显著增加并发症的发生率。

Objective To study the relationship between different puncturing sites at femoral artery in patients un- dergoing coronary angiography and postoperative complications. Methods A total of 317 patients undergoing selected fort diagnostic coronary angiography were randomly divided into three groups with femoral artery punctured at upper, medial, or lower site respectively. The distance from internal orifice on punctured femoral artery to groin ligament of upper, medial and lower group was 0. 1 -1.5 cm, 1.6-2. 5 cm,and 〉2.5 cm respectively. The distance was confirmed once after puncture by measuring the puncturing angle and the length of needle inserted into the tissue. Postoperative complications were analyzed. Results Compared with upper puncturing group, the incidence of postoperative complications in medial or lower puncturing group was significantly increased （P〈0. 05）. The complication incidence was increased as the age increased. The attempt times of puncturing did not increase postoperative complications if the performance of puncturing was proper. Conclusion Lower puncturing site at femoral artery and age significantly increase the incidence of the postoperative complications.