摘要
目的观察接受桡动脉冠脉介入诊疗患者术后急性桡动脉闭塞(RAO)的发生率,并探讨影响患者桡动脉冠脉介入诊疗术后发生 RAO 的相关因素。方法 7215例行桡动脉冠脉介入诊疗的患者根据术后是否发生 RAO 分为正常组和 RAO 组,通过多因素 Logistic 回归分析 RAO 的危险因素。结果 7215例患者中共有68例患者术后发生急性桡动脉闭塞(0.94%),与正常组相比,RAO组患者中女性、糖尿病和既往曾行桡动脉冠脉介入诊疗患者的比例较高,RAO 组术中平均肝素用量明显低于正常组(3723 IU±556 IU vs 7603 IU±1533 IU,P<0.01),术后压迫时间长于正常组(103.8min±23.3 min vs 87.7 min±31.2 min,P=0.02),而亲水涂层鞘管的应用比例要低于正常组,且RAO 组患者应用7 F 动脉鞘的比例较高(11.8%vs 1.8%,P<0.01);Logistic 回归分析显示,术中选择7 F 动脉鞘管、肝素用量偏低、术后压迫桡动脉时间过长及使用非亲水涂层动脉鞘是影响 RAO发生的独立危险因素。结论桡动脉冠脉介入诊疗术中选择尺寸合适的动脉鞘管、足够强度的抗凝治疗、避免术后过长时间的压迫止血以及选用亲水涂层动脉鞘管有利于减少 RAO 的发生率。
Objective To elucidate the incidence and risk factors of acute radial artery occlusion （RAO） following transradial percutaneous coronary intervention（TRI）. Methods A total of 7215 patients who underwent TRI were divided into normal group and RAO group, according to whether the patient without and with RAO . Risk factors of RAO were analyzed by logistic regression model. Results Acute RAO occurred in 68 patients（0. 94% ）. As compared to the patients in normal group, there were more female and diabetes mellitus patients in RAO group. The dosage of heparine used in the operational procedure in RAO group were significantly less than normal group （ 3723 IU ± 556IU vs 7603 IU ±1533 IU, P 〈 0. 01 ）. The pest-procedure duration of high-pressure compression hemostais were longer in RAO patients than normal patients （103.8 min ±23.3min vs 87. 7 min ± 31.2min, P = 0. 02）. Logistic regression analyses showed that the dosage of heparine used in the procedure, the category and size of sheath and the post-procedure compression time were independent risk factors for RAO. Conclusion The incidence of RAO can be minimized by appropriate anticoagulation, proper sheath selection, and avoiding prolonged durarion of high- pressure compression hemostasis following the procedure.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第22期1531-1534,共4页
National Medical Journal of China
关键词
经皮冠状动脉介入治疗
桡动脉闭塞
亲水涂层动脉鞘
Pereutaneous transcoronary intervention
Radial artery occlusion
Hydrophilic sheath
