改良新型臂托在经桡动脉行冠状动脉介入手术中的应用效果

Effects of new and modified arm support on trans-radial coronary intervention

目的探讨一种用于经桡动脉途径行冠状动脉介入治疗时，可提供双侧桡动脉穿刺臂托装置的研制及临床应用效果。方法设计并研制供双侧桡动脉穿刺臂托装置。选择2017年5—6月在北京协和医院心脏导管室经桡动脉途径行冠状动脉介入治疗的患者100例，采用随机数字表法，随机分为观察组和对照组，每组各50例。观察组采用新型臂托装置暴露桡动脉穿刺点的方法，对照组采用传统木质臂托，比较两组穿刺效果。结果观察组桡动脉入路准备时间（1．58±0．56）min，穿刺置入桡动脉鞘管所需时间（3．51±0．44）min，均少于对照组，差异有统计学意义（t值分别为9．511、8．740；P〈0．05）。96％的患者对新型臂托装置感觉舒适，80％的医生操作体验满意度为优，均高于对照组（P〈0．05）。结论本新型可提供双侧桡动脉穿刺臂托装置性能稳定可靠，与传统方法相比，缩短了护士桡动脉入路准备时间，缩短了医生从桡动脉穿刺至桡动脉置管所需时间，增加了患者使用舒适度，医生体验满意度较高。具有使用便捷性和灵活性，可在心脏导管室中进行推广使用。

Objective To develop an arm support used for bilateral puncture during trans-radial coronary intervention （TRI） and to explore its effects. Methods The arm support used for bilateral radial artery puncture was designed and developed. Totally 100 patients who received TRI in the Cardiac Catheterization Room of Peking Union Medical College Hospital between May and June 2017 were selected and equally divided into an observation group and a control group according to the random number table. Patients in the observation group were served with the new arm support to reveal the points for radial artery puncture, while patients in the control group used the conventional wooden arm support. The effect of puncture was compared between the patients in the two groups. Results The time used for preparation before radial artery puncture was （1.58 ± 0.56） min and the time need for puncturing and placing sheathing canal in the radial artery was （3.51 ± 0.44） min in the patients in the observation group, both shorter than those of the patients in the control group （t=9.511, 8.740; P〈 0.05）. Totally 96% of the patients felt comfortable with the new arm support, and the operation experience satisfaction in 80% of the doctors was excellent, both higher than those of the patients in the control group. Conclusions The performance of this new arm support for bilateral radial artery puncture is stable and reliable. Compared with conventional methods, the time used for preparation before radial artery puncture is shortened for nurses, and the time needed for puncturing and placing sheathing canal in the radial artery is shortened for doctors. The patients feel more comfortable when using this new arm support, and the doctors have a higher experience satisfaction. The new arm support is convenient and flexible for use, and may be used and promoted in cardiac catheterization rooms.