不同导引导丝在经桡动脉径路冠状动脉造影中的应用

Application of different guide wire in transradial coronary angiography

目的：探讨不同导引导丝对经桡动脉径路冠状动脉造影的影响。方法：选择2009年11月～2013年1月在我院成功行桡动脉径路冠状动脉造影的患者238例，按照采用不同导引导丝分为两组：A组（119例）采用普通J型交换导丝，B组（119例）采用泥鳅交换导丝。比较上述两种导丝的通过性、支撑力、并发症发生率。结果：泥鳅交换导丝通过性明显好于普通 J 型交换导丝，肘关节通过率（98.3％比87.4％）、头臂干通过率（100％比96.2％）明显高于普通J型交换导丝（P＜0.01或＜0.05）。普通 J 型交换导丝的导丝支撑转动导管力明显优于泥鳅交换导丝，左冠脉造影成功率明显高于泥鳅交换导丝（98.3％比89.1％，P＜0.01）。两组并发症发生率无明显差异。结论：冠脉造影导丝应首选普通J型交换导丝，不能通过时改用择泥鳅导丝。

Objective：To explore influence of different guide wire on transradial coronary angiography （CAG）. Methods：A total of 238 patients,who received successful transradial CAG in our hospital from Nov 2009 to Jan 2013,were selected.According to kinds of guide wire,they were divided into group A （n=119,used ordinary J type exchange guide wire）and group B （n=119,used loach exchange guide wire.Trafficability,supporting force and incidence rate of complications were compared between above two groups.Results：The trafficability of loach exchange guide wire was significantly better than that of ordinary J type exchange guide wire,the pass rates of elbow joint （98.3% vs.87.4%）and brachiocephalic trunk （100% vs.96.2%）were significantly higher than those of ordinary J type exchange guide wire （P〈0.01 or 〈0.05）.For guide wire support to rotate catheter,ordinary J type exchange guide wire had obvious advantages,its success rate of left CAG （98.3%）was significantly higher than that of loach exchange guide wire （89.1%）,P〈0.01.There were no significant differences in incidence rate of complications between two groups.Conclusion：Ordinary J type exchange guide wire could be preferred in coronary angiog-raphy,and loach exchange guide wire can be considered if the former can＇ pass.