摘要
目的:评估耳穴贴压降低介入诊疗中桡动脉穿刺后血管痉挛[包括桡动脉痉挛(radial artery spasm,RAS)和冠状动脉痉挛(coronary artery spasm,CAS)]和迷走反射的作用及临床应用价值。方法:480例经桡动脉穿刺行冠脉介入诊疗的患者,随机分为观察组(224例)和对照组(256例)。对照组行冠脉介入术治疗,围术期给予常规护理;观察组行冠脉介入术前12 h开始耳穴贴压治疗,穴取交感、神门、皮质下、内分泌、心、肾、肾上腺,术前至术后12 h内每隔2 h按压1次,每次每穴按压1 min。比较两组患者在穿刺过程中血管痉挛和迷走反射的发生率,并记录硝酸甘油注射液、多巴胺注射液、阿托品注射液等血管活性药物的使用率。结果:观察组血管痉挛的发生率为4.9%(11/224),低于对照组的13.3%(34/256,P<0.01);观察组迷走反射的发生率为7.1%(16/224),低于对照组的19.5%(50/256,P<0.01)。观察组患者硝酸甘油注射液使用率为3.6%(8/224),低于对照组的14.8%(38/256,P<0.01);观察组患者阿托品注射液使用率为7.1%(16/224),低于对照组的15.6%(40/256,P<0.01);观察组患者多巴胺注射液使用率为6.3%(14/224),低于对照组的15.2%(39/256,P<0.01)。结论:耳穴贴压对降低经桡动脉穿刺行冠脉介入诊疗时的血管痉挛和迷走反射发生率具有确切疗效。
Objective To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm（RAS） and coronary artery spasm（CAS）. Methods A total of 480 patients were randomized into an observation group（224 cases） and a control group（256 cases）. Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan（AH6 a）, Shenmen（TF4）, Pizhixia（AT4）, Neifenmi（CO18）, Xin（CO15）, Shen（CO10）, Shenshangxian（TG2 p）, 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections. Results The incidence of angiospasm was 4.9%（11/224） in the observation group, which was lower than 13.3%（34/256） in the control group（P0.01）. The incidence of vagal reflex of the observation group was 7.1%（16/224）, which was lower than 19.5%（50/256） of the control group（P0.01）. The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6%（8/224）, 7.1%（16/224）, 6.3%（14/224） respectively in the observation group, which were lower than 14.8%（38/256）, 15.6%（40/256）, 15.2%（39/256） in the control group（all P0.01）. Conclusion Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第2期137-140,共4页
Chinese Acupuncture & Moxibustion
基金
河南省高校科技创新团队支持计划项目:13IRTSTHN012
关键词
桡动脉穿刺
血管痉挛
迷走反射
耳穴贴压
介入
radial artery puncture, vasospasm
vagus reflex, auricular point slicking
inlervention
