经远端桡动脉腕背支和经典桡动脉穿刺途径行冠状动脉造影的临床对比研究

Clinical comparison of coronary angiography by distal radial carpal dorsal branch puncture and classical radial artery puncture

目的评价经远端桡动脉腕背支进行冠状动脉造影的有效性、安全性及可行性。方法选择2018年5~11月于贵阳市第三人民医院行冠状动脉造影术的患者150例,其中行经远端桡动脉腕背支穿刺者为研究组,行经典桡动脉穿刺者为对照组,每组75例。比较两组的临床特点、手术成功率、穿刺成功率、术后加压包扎时间及穿刺并发症。结果两组穿刺成功率、手术成功率的差异无统计学意义(P>0.05),研究组术后加压包扎时间低于对照组[(4.7±0.7)h比(6.8±1.6)h,P=0.000];研究组穿刺并发症的总发生率、穿刺部位血肿发生率低于对照组(4.0%比13.3%,P=0.042;0.0%比1.7%,P=0.023);虽假性动脉瘤、动脉闭塞发生率低于对照组,动脉痉挛发生率高于对照组,但差异均无统计学意义(P>0.05)。结论经远端桡动脉腕背支穿刺途径行冠状动脉造影是有效、安全、可行的,可作为经典桡动脉穿刺途径的备选途径。

Objective To evaluate the effectiveness,safety and feasibility of coronary angiography through the distal radial artery dorsal carpal branch.Methods A total of 150 patients underwent coronary angiography in Guiyang Third People’s Hospital from May to November,2018.The patients were divided into two groups,the study group was underwent coronary angiography via the dorsal carpal branch of distal radial artery,the control group was underwent coronary angiography via classical radial artery puncture,75 cases were in each group.The clinical features,surgical success rate,puncture success rate,postoperative compression bandaging time and puncture complications were compared between the two groups.Results There were no significant differences in the puncture success rate and the surgical success rate between the two groups(P>0.05).The duration of compression bandaging in the study group was slightly lower than that in the control group[(4.7±0.7)h vs.(6.8±1.6)h,P=0.000].Compared with the control group,the incidence of hematoma and pseudoaneurysm in the study group was lower,the incidence of arterial spasm was higher in the study group,but there were no significant difference(P>0.05).Conclusions Percutaneous coronary angiography via the dorsal carpal branch of the distal radial artery is effective,safe and feasible,which can be used as an alternative approach.