摘要
目的分析总结经桡动脉途径行冠脉造影和介入治疗时的常见问题和并发症、以及观察处理体会。方法回顾自2005年8月～2009年5月该院319例次经桡动脉途径冠脉造影／介入治疗（TRA／TRI），对其中的失败原因和有关并发症进行分析．结果319例次TRA／TRI中、有29例次经桡动脉途径失败、改行经股动脉途径获得成功。失败原因包括：因桡动脉细小或搏动微弱而穿刺失败；导引钢丝进入动脉夹层；桡动脉痉挛导管无法操作；桡动脉中段、锁骨下动脉、头臂干或升主动脉等严重迂曲、畸形或主动脉根部重度扩张或冠状动脉开口异常，导管无法到位。在围术期并发症包括前臂血肿；穿刺部位出血；桡动脉痉挛、而拔鞘困难；术中发生心室颤动等。未发生桡动脉闭塞和前臂骨筋膜室综合症等重大并发症：结论TRA／TRI虽然具有许多优点，但需要术者熟练掌握桡动脉穿刺技巧，提高桡动脉穿刺成功率，熟练掌握导管、导丝操作技术，避免桡动脉痉挛的发生，预防血肿、出血和室颤等并发症。
Aim To analyze and summarize the complications and treatments in coronary angiography and intervention therapy through radial artery. Methods Retrospective analysis of the causes of failure and complications in 319 patients were made, who underwent coronary angiography or intervention therapy through radial artery from August 2005 to May 2008 in our hospital. Results 29 cases failed among a total of 319 patients who underwent coronary angiography or intervention therapy. The reasons of failure included radial artery slender or pulsate faintness, guide wire fit-into dissection, radial artery spasm, radial artery midpiece or subclavian artery or hrachiocephalic artery or ascending aorta is being tortuous or abnormal; aortic root distension extremely or coronary artery debouchement abnormal. Conclusion Though coronary angiography and intervention therapy through radial artery has many benefits,killful technique is needed to successful radial artery puncture. Practiced handle catheter and guide wire is important to decrease the complications such as radial artery spasm,local hematoma or bleeding, and ventricular fibrillation.
出处
《安徽医药》
CAS
2010年第1期60-62,共3页
Anhui Medical and Pharmaceutical Journal
关键词
桡动脉
冠脉介入
失败原因
并发症
radial artery
coronary artery intervention therapy
cause of failure
complication
