左侧桡动脉和右侧桡动脉入路TACE治疗的对比分析

Left transradial approach versus right transradial approach for TACE treatment:a comparative study

目的分析比较左右侧桡动脉不同入路在TACE手术治疗中的影响。方法 回顾性分析了2021年6月至2022年5月在河南省中医院接受常规TACE治疗的174例肝癌患者,其中小于65岁:左侧桡动脉入路52例,右侧桡动脉入路54例;大于65岁:左侧桡动脉入路32例,右侧桡动脉入路36例。对比分析左侧桡动脉入路和右侧桡动脉入路的并发症发生情况,插管至腹腔干的透视时间、手术整体透视时间和射线剂量。结果 小于65岁患者中左侧桡动脉入路组和右侧桡动脉入路组插管至腹腔干透视时间、手术整体透视时间、射线剂量及穿刺点并发症发生率差异无统计学意义(P>0.05);在大于65岁患者中,左侧桡动脉入路和右侧桡动脉入路的穿刺点并发症发生率未见明显差异,无统计学意义(P>0.05)。左侧桡动脉入路插管至腹腔干透视时间、手术整体透视时间及射线剂量均低于右侧桡动脉入路[(60.3±28.3) s vs (86.3±45.2) s, P=0.003];[(11.2±4.5) min vs (14.3±6.3) min,P=0.030];[(452.2±121.7) mGy vs (563.8±181.5) mGy,P=0.022],差异有统计学意义。结论左侧桡动脉入路和右侧桡动脉入路在常规TACE治疗中穿刺点并发症发生率没有明显差异,但左侧桡动脉入路在大于65岁的老年患者中能明显减少手术透视时间和射线剂量。

Objective To compare the effect of left transradial approach(TRA)with right TRA in performing transcatheter arterial chemoembolization(TACE)for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of a total of 174 HCC patients,who received conventional TACE via radial access at Henan Provincial Hospital of Traditional Chinese Medicine of China between June 2021 and May 2022,were retrospectively analyzed.Among the 174 patients,104 patients were≤65 years old,of whom 52 received TACE by using left TRA and 54 received TACE by using right TRA;68 patients were>65 years old,of whom 32 received TACE by using left TRA and 36 received TACE by using right TRA.The complications,fluoroscopy time spent for catheterization into celiac trunk,surgical total fluoroscopy time and radiation dose were compared between the left TRA group and right TRA group.Results In the patients≤65 years old,there were no statistically significant differences in the fluoroscopy time spent for catheterization into celiac trunk,the surgical total fluoroscopy time,the radiation dose and the incidence of complications between the left TRA group and the right TRA group.In the patients>65 years old,no statistically significant difference in the incidence of complications existed between the left TRA group and the right TRA group(P>0.05),while the fluoroscopy time spent for catheterization into celiac trunk((60.3±28.3)s vs(86.3±45.2)s,P=0.003),the surgical total fluoroscopy time((11.2±4.5)min vs(14.3±6.3)min,P=0.030)and the radiation dose((452.2±121.7)mGy vs(563.8±181.5)mGy,P=0.022)in the left TRA group were remarkably lower than those in the right TRA group,the differences were statistically significant.Conclusion In conventional TACE,there is no obvious difference in the incidence of puncture point-related complications between using left TRA and using right TRA;but in the patients≤65 years old,the use of left TRA can significantly reduce the surgical total fluoroscopy time and radiation dose.