摘要
目的探讨重复经桡动脉途径冠状动脉介入术后桡动脉狭窄或闭塞的相关危险因素。方法收集2017年11月至2018年11月新疆维吾尔自治区人民医院心血管内科重复经同一桡动脉行冠状动脉介入术的患者120例,按术后是否发生桡动脉狭窄或闭塞分为狭窄或闭塞组及正常组,比较两组患者的临床特征,并通过多因素Logistic回归分析重复经桡动脉冠状动脉介入术后桡动脉狭窄及闭塞的影响因素。结果在120例患者中,正常99例,桡动脉狭窄及闭塞21例,桡动脉狭窄或闭塞的发生率为17.50%。狭窄或闭塞组女性比例、年龄、肝素使用量、鞘管留滞时间大于正常组[42.86%(9/21)比15.15%(15/99),(63±8)岁比(57±11)岁,8.00(7.00,9.25)k IU比7.00(2.00,8.00)k IU,340(268,365)min比270(30,300)min](P<0.05),桡动脉内径小于正常组[2.1(1.93,2.23)mm比2.30(2.10,2.40)mm](P<0.05)。单因素分析结果显示,性别、年龄、桡动脉内径、肝素使用量、鞘管留滞时间是桡动脉狭窄或闭塞的影响因素(P<0.05)。多因素回归分析结果显示,女性、糖尿病、鞘管留滞时间均为桡动脉狭窄或闭塞发生的危险因素(P<0.05)。结论术后留置鞘管时间过长、女性、既往糖尿病病史在桡动脉介入术中可增加术后桡动脉狭窄或闭塞的发生风险,减少鞘管留置时间、积极控制血糖、加强对女性患者术后桡动脉的管理可降低经桡动脉介入术后桡动脉狭窄及闭塞的发生率。
Objective To investigate the risk factors of radial artery stenosis or occlusion after repeated transradial coronary intervention. Methods A total of 120 patients who underwent coronary intervention with the same radial artery in the Department of Cardiology of the People’s Hospital of Xinjiang Uygur Autonomous Region from Nov. 2017 to Nov. 2018 were enrolled. According to whether or not radial artery stenosis or occlusion occurred after operation,they were divided into a stenosis/occlusion group and a normal group. The clinical characteristics of the two groups were compared,and the factors affecting radial artery stenosis and occlusion after repeated transradial coronary intervention were analyzed by multivariate Logistic regression analysis. Results Of the 120 patients,99 were in the normal group,21 in the radial stenosis/occlusion group,and the incidence of radial stenosis and occlusion was 17. 50%. The female proportion,age,heparin usage,and sheath retention time in the stenosis/occlusion group were larger than those in the normal group[42. 86%( 9/21) vs15. 15%( 15/99),( 63 ± 8) year vs( 57 ± 11) year,8. 00( 7. 00,9. 25) k IU vs 7. 00( 2. 00,8. 00) k IU,340( 268,365) min vs270( 30,300) min]( P < 0. 05),the internal diameter of the radial artery was smaller than that of the normal group[2. 1( 1. 93,2. 23) mm vs 2. 30( 2. 10,2. 40) mm]( P < 0. 05). The univariate analysis showed that gender,age,diameter of radial artery,heparin usage,and sheath retention time were the influencing factors of radial artery stenosis or occlusion( P <0. 05). Multivariate regression analysis showed that female gender,diabetes,and sheath retention time were all risk factors for radial artery stenosis or occlusion( P < 0. 05). Conclusion Long indwelling time of sheath after surgery,female gender,previous history of diabetes can increase the risk of postoperative radial stenosis or occlusion in the brachial artery intervention,so reducing sheath indwelling time,active control of blood sugar,strengthening the postoperative manageme
作者
刘小方
李国庆
程慧
关娜
LIU Xiaofang;LI Guoqing;CHENG Hui;GUAN Na(Shihezi University School of Medicine,Shihezi 832000,China;Department of Cardiology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Ultrasound,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《医学综述》
2020年第9期1823-1827,共5页
Medical Recapitulate
基金
新疆维吾尔自治区自然科学基金(2017D01C133)。
关键词
冠状动脉介入术
桡动脉
狭窄或闭塞
Coronary intervention
Radial artery
Stenosis or occlusion