指舞运动在经桡冠状动脉介入术后预防桡动脉闭塞的效果评价

Effect evaluation of finger movements on preventing radial artery occlusion after transradial coronary intervention

目的:探索经桡介入术后的指舞运动对于桡动脉闭塞(RAO)的预防效果。动态观测病人术后桡动脉血流动力学参数变化情况,分析指舞运动对于早期和晚期RAO的影响。方法:纳入择期行冠状动脉造影及介入治疗的171例病人,随机分为对照组89例和观察组82例。观察组在术后开展3 h的指舞运动,对照组无上述操作。分别在穿刺前、术后第3天和术后1个月检测2组病人桡动脉内膜厚度、直径以及血流速度峰值等指标,动态观测上述指标的变化,分析早期和晚期RAO情况。结果:2组病人的年龄、性别、吸烟、合并疾病等临床特征差异均无统计学意义(P>0.05)。观察组桡动脉直径以及内膜厚度在术前、术后3 d及术后1个月与同时期对照组相比差异均无统计学意义(P>0.05),观察组病人的桡动脉血流速度峰值在术前与对照组病人相比差异无统计学意义(P>0.05),但观察组桡动脉血流速度峰值在术后3 d及术后1个月均高于对照组(P<0.05)。术后3 d,观察组早期RAO率为5.7%(4/70),低于对照组的16.3%(13/80)(P<0.05)。术后1个月,观察组未发生RAO,闭塞率为0%(0/68),低于对照组的14.9%(11/74)(P<0.01)。观察组前臂肿胀及穿刺点渗血等不良反应发生率与对照组相比差异无统计学意义(P>0.05)。结论:指舞运动有助于提升早期桡动脉血流速度,能显著降低冠状动脉造影术后早期和晚期RAO的发生,且未明显影响不良反应发生率。术后指舞运动是一种简便、安全有效的RAO防治策略。

Objective:To explore the effect of finger movements on preventing radial artery occlusion(RAO),the changes of the postoperative hemodynamic parameters of the radial artery in patients were observed dynamically,and the effects of the finger dance exercise on the early and late RAO occurrence were analyzed.Methods:A total of 171 patients undergoing elective coronary angiography and interventional therapy were randomly divided into control group(89 patients)and observation group(82 patients).The observation group carried out finger movements for 3 h after surgery,and none was performed in the control group.The thickness,diameter and peak flow velocity of the radial artery were measured before puncture,3 days and 1 month after surgery.The changes of the above indicators were dynamically observed,and the early and late RAO occurrence were analyzed.Results:The age,gender,smoking,combined disease and other clinical characteristics of patients in the two groups were not significantly different(P>0.05).The radial artery diameter and intimal thickness in the observation group had no statistical significance compared with the control group in the same period before surgery,3 days and 1 month after surgery(P>0.05).The peak flow velocity of radial artery in the observation group had no statistical significance compared with the control group before surgery(P>0.05),but the peak flow velocity of radial artery in the observation group was higher than that in the control group 3 days and 1 month after surgery(P<0.05).On the third day after surgery,the early RAO rate in the observation group was 5.7%(4/70),lower than the 16.3%(13/80)in the control group(P<0.05).At 1 month after surgery,no RAO occurred in the observation group,and the occlusion rate was 0%(0/68),which was lower than 14.9%(11/74)in the control group(P<0.01).The incidence of adverse reactions such as forearm swelling and puncture point blood infiltration was not significantly different between the two groups(P>0.05).Conclusions:Finger movements helps to improve the early radial artery blood flow velocity,can significantly reduce the occurrence of early and late RAO after coronary angiography,and does not significantly affect the incidence of adverse reactions.Postoperative finger dance exercise is a simple,safe and effective prevention strategy for RAO.