经桡动脉全脑血管造影术在青年缺血性脑血管病诊断中的应用

Application of whole brain angiography via radial approach in young patients for the diagnosis of ischemic cerebrovascular disease

目的评估青年缺血性脑血管病患者经桡动脉穿刺行DSA的可行性及安全性。方法连续纳入解放军第八一医院神经内科行全脑DSA的青年脑血管病患者100例,采用计算机随机数字法将患者分为桡动脉组50例和股动脉组50例,对比分析两组患者穿刺时间、穿刺成功率、选择性造影成功率、曝光时间、并发症发生率。结果 (1)桡动脉组穿刺时间明显长于股动脉组,分别为(3.00±0.50)和(1.50±0.25)min,差异有统计学意义(t=18.97,P<0.01);穿刺成功率[98.0%(49例)比100%(50例)]、选择性造影成功率(100.0%比100.0%)及曝光时间[(5.3±2.2)比(4.8±1.7)min]两组差异均无统计学意义(均P>0.05)。(2)桡动脉组并发症发生率(4.0%,2例)明显低于股动脉组(18.0%,9例),两组差异有统计学意义(χ2=5.01,P<0.05)。结论经桡动脉穿刺行全脑DSA在青年脑血管病患者中安全可行。

Objective To assess the feasibility and safety of transradial puncture route for digital subtraction angiography （DSA）in young patients with ischemic cerebrovascular disease. Methods One hundred young patients with cerebrovascular disease who underwent whole brain angiography at the Department of Neurology,the 81 st Hospital of PLA were enrolled. They were divided into either a radial group （n =50）or a femoral group （n = 50）using a computer random number method. The time of puncture,success rate of puncture,success rate of selective angiography,exposure time,and incidence of complications were compared and analyzed. Results （1）The puncture time of the radial group was significantly longer than that of the femoral group,they were 3. 00 ± 0. 50 min and 1. 50 ± 0. 25 min respectively. There was significant difference （t = 18. 97,P ＆lt; 0. 05）. There were no significant differences in the success rate of puncture （98% vs. 100%）,success rate of selective angiography （100% vs. 100%）,and exposure time （5. 3 ± 2. 2 vs. 4. 8 ± 1. 7 min）between the two groups （all P ＆gt; 0. 05）. （2）The incidence of complications of the radial group （4%,n = 2）was significantly 1ower than that of the femoral group （18%,n = 9 ）. There was significant difference between the two groups （χ2 = 5. 01,P ＆lt; 0. 05 ）. Conclusion Transradial route puncture for whole brain DSA in young patients with cerebrovascular disease is safely and feasible.