J型导丝以J弯塑形进桡动脉鞘的操作在冠状动脉造影中的应用

Application of J-type guidewire into radial artery sheath by J-bend in coronary angiography

目的:探讨J型导丝以J弯塑形进鞘的操作应用于经右侧桡动脉途径行冠状动脉造影时的效果。方法:选取2020年9月至2022年5月我院收治的594例经右桡动脉行冠状动脉造影的患者为研究对象,分为J型导丝塑形组(199例)、J型导丝组(197例)及A弯导丝组(198例)。J型导丝塑形组在进桡动脉鞘时将J型导丝远端保持J弯塑形,而其余两组导丝则以常规操作进鞘。记录3组患者从导丝进鞘至抵达主动脉瓣的操作时间、X线暴露时间、外周动脉出血例数及更换导丝例数。结果:J型导丝塑形组外周动脉出血发生率低于其他两组(P<0.05),导丝操作时间及X线暴露时间均短于其他两组(P<0.05)。J型导丝塑形组的导丝更换率低于J型导丝组(P<0.05)。结论:在进桡动脉鞘时将J型导丝远端保持J弯塑形行冠状动脉造影,不仅可降低外周动脉出血发生率,还能降低导丝更换率,缩短操作时间与医患的X线暴露时间。

Objective:To investigate the effect of J-type guidewire into the sheath by J-bend in coronary angiography via the right radial artery.Methods:594 patients who underwent coronary angiography via the right radial artery in our hospital from September 2020 to May 2022 were selected as the research objects.They were divided into J-type guidewire shaping group(199 cases),J-type guidewire group(197 cases)and A-bend guidewire group(198 cases).In the J-type guidewire shaping group,the distal end of the J-type guidewire was kept in the J-bend shape when entering the radial artery sheath,while the other two groups of guidewires were entered into the sheath by conventional operation.The operation time,X-ray exposure time,the number of cases of peripheral arterial bleeding,and the number of cases of wire replacement were recorded in the three groups from the insertion of the guidewire into the sheath to the arrival of the aortic valve.Results:The incidence of peripheral arterial bleeding in the J-type guidewire shaping group was lower than that in the other two groups(P<0.05),and the guidewire operation time and X-ray exposure time were shorter than those in the other two groups(P<0.05).The guidewire replacement rate of the J-type guidewire shaping group was lower than that of the J-type guidewire group(P<0.05).Conclusion:When entering the radial artery sheath,keeping the distal J-type guidewire in J-bend shape for coronary angiography can not only reduce the incidence of peripheral arterial bleeding,but also reduce the guidewire replacement rate,shorten the operation time and the X-ray exposure time of doctors and patients.