经桡动脉入路介入治疗恶性肿瘤的可行性和安全性分析

Analysis of the feasibility and safety of transradial access interventional treatment of malignant tumor

目的探讨经桡动脉入路(TRA)介入治疗恶性肿瘤的可行性和安全性。方法选取行TRA介入治疗的50例恶性肿瘤患者,共顺利完成87例次手术。观察记录穿刺时间,穿刺次数、大导管置管曝光时间(从穿刺成功到目标血管成功置管)、压迫时间、桡动脉闭塞率、术后基本的日常生活活动能力评分。结果穿刺中位时间2.8 min,平均(2.3±1.6)min;穿刺中位次数2次,平均(1.7±1.2)次;大导管置管中位曝光时间13.0 min,平均(16.5±7.4)min;压迫中位时间3 h,平均(3.5±1.1)h;手术成功率100%。术前,Barthel指数中位评分为73分,平均71分;术后,中位评分为73分,平均70分。结论TRA介入治疗恶性肿瘤安全、可行,尤其适合难以平卧、淋巴性水肿不能暴露股动脉穿刺区的恶性肿瘤患者,在提高患者舒适度及降低护理成本等方面存在明显优势,是一种较为理想的选择。

Objective To investigate the feasibility and safety of transradial access(TRA)interventional treatment for malignant tumor.Method A total of 50 patients with malignant tumors who underwent TRA interventional treatment were selected,and 87 operations were completed.The puncture time,the number of punctures,exposure time of large catheter placement(from a successful puncture to successful placement of the target vessel),compression time,radial ar-tery occlusion rate,and basic activity of daily living score after surgery were observed and recorded.Result The median puncture time was 2.8 min,with an average of(2.3±1.6)min;the median number of punctures was 2 times,with an aver-age of(1.7±1.2)times;the median exposure time for large catheter placement was 13 min,with an average of(16.5±7.4)min;the median time of compression was 3 h,with an average of(3.5±1.1)h;the success rate of surgery was 100%.Be-fore surgery,the median score of the Barthel index was 73 points,with an average 71 points;after surgery,the median score was 73 points,with an average 70 points.Conclusion TRA interventional treatment for malignant tumors is safe and feasible,which is especially suitable for patients with malignant tumors who are difficult to lie down and cannot ex-pose the femoral artery puncture area due to lymphedema.It has obvious advantages in improving patients comfort feel-ing and reducing nursing cost.It is an ideal choice.