摘要
目的探讨经桡动脉途径（TRA）行全脑血管造影的安全性和可行性。方法前瞻性纳入温州市中心医院神经外科2015年9月至2016年5月行脑血管造影的300例患者，并按随机数字表法分为TRA组（152例）和经股动脉途径组（TFA组，148例）。比较两组的并发症发生率及图像质量评分。结果两组在3d内发生脑梗死、短暂性脑缺血发作、心肌梗死的比较差异无统计学意义（P〉0．05）。穿刺点血肿：TRA组5例，TFA组17例；动脉夹层：TRA组1例，TFA组10例，两组比较差异有统计学意义（P〈0．05）；两组的动静脉瘘、血管闭塞比较差异无统计学意义（P〉0．05）。造影质量总评分：TRA组为（11．58±0．90）分，TFA组为（11．71±1．10）分，两组比较差异无统计学意义（P〉0．05）。各条血管的造影质量评分：右侧颈总动脉，TRA组为（2．96±0．23）分，TFA组为（2．94±0．35）分；左侧颈总动脉，TRA组为（2．93±0．30）分，TFA组（2．97±0．16）分；右侧椎动脉，TRA组为（2．924-0．29）分，TFA组为（2．82±0．53）分；左侧椎动脉，TRA组为（2．76±0．62）分，TFA组为（2．97±0．16）分。两组的总评分、两侧颈总动脉及右侧椎动脉的评分比较差异无统计学意义（P〉0．05）；在Ⅲ型主动脉弓右侧椎动脉中TRA组评分高于TFA组，两组比较差异有统计学意义（P〈0．05）。结论TRA能达到不亚于TFA的造影质量，而且局部穿刺点的并发症发生率更少，患者舒适度更高。Ⅲ型主动脉弓患者选择TRA行右侧颈总动脉及右侧椎动脉造影更有优势。
Objective To explore the application of transradial artery （TRA） approach in cerebral angiography. Methods A total of 300 patients, at Department of Neurosurgery of Wenzhou Central Hospital from September 2015 to May 2016, underwent cerebral angiography and were divided into TRA group （n = 152） and transfemoral artery （TFA） group （n = 148 ）. The complication rates and image quality scores were compared between the groups. Results In both groups, 1 patient suffered from cerebral infarction within 3 days. Two patients suffered from transient ischemic attach （TIA） in TRA group and 3 in TFA. No patient reported myocardial infarction in either group. There was no significant difference between the 2 groups （P 〉0.05）. In TRA group, 5 patients had hematoma at the access site and 17 in TFA. One patient reported vessel dissection in TRA group and 10 in TFA. The occurrence rates of hematoma at the access site and vessel dissection in TRA group were significantly lower than those in TFA （P 〈 0.05 ）. No arteriovenous fistula occurred in TRA group and 1 was observed in TFA. No vessel occlusion occurred in either group. There was no significant difference between the groups （ P 〉 0.05 ）. The mean score of the image quality of all 4 arteries was 11.58±0.90 in TRA group and 11.71 ±1.10 in TFA group. There was no significant difference between the 2 groups （ P 〉 0.05 ）. The mean score of each artery was as follows ： RCCA （2.96±0.23 in TRA; 2.94 ±0.35 in TFA）, LCCA （2.93 ±0.30 in TRA; 2.97 ±0. 16 in TFA）, RVA （2.92 ±0.29 in TRA; 2.82 ±0.53 in TFA） and LVA （2.76 ±0.62 in TRA; 2.97 ±0.16 in TFA）. The overall scores of all four arteries and the subscores of RCCA, LCCA and RVA had no significant difference between the 2 groups （ P 〉 0.05 ）. The subscore of RVA of type Ⅲ aortic patients in TRA group was significantly higher than that in TFA group （ P 〈 0.05 ）. Conclusions The image quality of TRA is comparable to that of TFA with low rate of hematoma
出处
《中华神经外科杂志》
CSCD
北大核心
2017年第11期1153-1156,共4页
Chinese Journal of Neurosurgery
基金
浙江省医药卫生科技计划（2016ZHB020）
温州市医药卫生科学研究项目（2015A01）
关键词
脑血管造影术
桡动脉
股动脉
前瞻性研究
Cerebral angiography
Radial artery
Femoral artery
Prospective studies
