摘要
目的探讨头臂干彩色多普勒超声(CDU)在经桡动脉行冠状动脉造影(CAG)入径选择中的临床价值。方法 700例行CAG的不稳定型心绞痛患者,随机分为试验组(n=362)和对照组(n=338)。试验组根据CDU筛查有无头臂干迂曲分为超声迂曲组和超声无迂曲组;对照组根据CAG筛查有无头臂干迂曲分为造影迂曲组和造影无迂曲组。分析CDU诊断头臂干迂曲的准确性,头臂干迂曲的发生率及其对CAG手术成功率、手术时间以及并发症的影响。结果试验组和对照组头臂干迂曲的发生率分别是9.4%、10.7%,差异无统计学意义(P>0.05)。CDU诊断头臂干迂曲的灵敏度为94.4%,特异度为98.7%。造影迂曲组手术成功率较超声迂曲组、超声无迂曲组、造影无迂曲组低(P<0.05),手术时间较超声迂曲组、超声无迂曲组、造影无迂曲组长(P<0.05)。超声迂曲组、超声无迂曲组、造影迂曲组、造影无迂曲组发生桡动脉痉挛分别有1、9、1、8例,造影迂曲组出现1例轻度主动脉夹层、12例导管打结。结论 CDU可为广大介入医师对头臂干迂曲患者选择更有效的CAG途经提供重要参考价值。
Aim To investigate the clinical value of color Doppler ultrasonography（CDU） for brachiocephalic trunk tortuosity in pathway selection of transradial coronary angiography（CAG）. Methods 700 patients with unstable angina pectoris undergoing CAG were randomly divided into the test group（n = 362） and the control group（n = 338）.According to the CDU screening with or without brachiocephalic trunk tortuosity,the test group was divided into CDU tortuosity group and CDU non-tortuosity group. According to the CAG screening with or without brachiocephalic trunk tortuosity,the control group was divided into CAG tortuosity group and CAG non-tortuosity group. Diagnostic accuracy of CDU for brachiocephalic trunk tortuosity,incidence of brachiocephalic trunk tortuosity and its effect on CAG operation success rate,operation time and complications were analyzed. Results The incidence rates of brachiocephalic trunk tortuosity in test group and control group were 9.4%,10.7% respectively,and the difference between the two groups was not statistically significant（P〈0.05）. The sensitivity of CDU diagnosis for brachiocephalic trunk tortuosity was 94.4%,the specificity was98.7%. Compared with CDU tortuosity group,CDU non-tortuosity group and CAG non-tortuosity group,the operation success rate was decreased and operation time was increased in CAG tortuosity group（P〈0.05）. The cases of radial artery spasm were 1,9,1,and 8 respectively in CDU tortuosity group,CDU non-tortuosity group,CAG tortuosity group and CAG non-tortuosity group. 1 case of mild aortic dissection and 12 cases of catheter knotting occured in CAG tortuosity group.Conclusion CDU may provide the important reference value for interventional physicians to select more effective CAG pathway in patients with brachiocephalic trunk tortuosity.
出处
《中国动脉硬化杂志》
CAS
北大核心
2017年第11期1159-1162,共4页
Chinese Journal of Arteriosclerosis
关键词
头臂干迂曲
彩色多普勒超声
冠状动脉造影
桡动脉
Brachiocephalic trunk tortuosity
Color Doppler ultrasonography
Coronary angiography
Radial artery
