摘要
目的探讨经桡动脉脑血管造影术学习曲线及该技术的安全性和可行性。方法回顾性选取2020年3月~2022年1月太和县人民医院新开展经桡动脉脑血管造影术60例,按手术时间顺序分为A(15例)、B(15例)、C(15例)、D(15例)4个阶段,对比各阶段间单根血管平均手术时间(min)、平均穿刺时间(min)、单根血管平均放射剂量(mGy)的差异,并绘制和分析经桡动脉脑血管造影术学习曲线。以C和D组(30例)合并为桡动脉组,并随机选取在本院已成熟开展的经股动脉脑血管造影术30例为股动脉组,对比两组之间造影成功率、单根血管平均手术时间、单根血管平均放射剂量、皮肤穿刺时间、手术后卧床时间、并发症、手术舒适程度等指标。结果经桡动脉脑血管造影初期学习曲线陡峭,随着手术例数的增加学习曲线逐渐平稳,30例以后单根血管平均手术时间、平均穿刺时间、单根血管平均放射剂量基本稳定。两种方法造影成功率(93.3%vs.93.3%)、单根血管平均手术时间[(6.81±1.35)min vs.(7.57±2.64)min]、单根血管放射剂量[(108.92±9.22)m Gy vs.(90.21±10.75)mGy]比较,差异无统计学意义(P>0.05)。桡动脉组术后卧床时间明显少于股动脉组[(6.46±1.40)h vs.(25.42±7.45)h],穿刺时间长于股动脉组[(1.76±0.39)min vs.(0.84±0.23)min],并发症发生率小于股动脉组(3.3%vs.24%),焦虑程度评分、动脉鞘相关疼痛评分[(1.96±0.80)分、(1.59±0.57)分]小于股动脉组[(4.20±1.50)分、(2.62±0.92)分],舒适感优于股动脉组[(1.70±0.60)分vs.(3.58±1.10)分],总体桡动脉途径倾向程度优于股动脉组(71.1%vs.13.4%),差异均有统计学意义(P<0.05)。结论经桡动脉脑血管造影安全可行,初始学习曲线陡峭,30例以后技术水平逐渐稳定,具有术后恢复时间快、并发症少、舒适度高、选择倾向高等优点。
Objective To explore the learning curve of transradial cerebral angiography and the safety and feasibility of this technique.Methods According to the time sequence,60 cases of transradial cerebral angiography in our hospital from March 2020 to January 2022 were selected and divided into four stages:A(15 cases),B(15 cases),C(15 cases)and D(15 cases)according to the order of operation.The differences in mean operation time(min),mean puncture time(min)and mean radiation dose(mGy)between the stages were compared.The learning curve of transradialcerebral angiography was drawn and analyzed according to the data.Then,the last 30 cases with transradial angiography were grouped into the experimental group,and 30 cases of transfemoral cerebral angiography which has been mature in our hospital were randomized intothe control group.The imaging success rate,average operation time of single vessel,radiation agent of single vessel,skin puncture time,operation recovery time,complications,operation comfort and other indexes were compared and analyzed.Results The learning curve of transradial cerebral angiography was steep at the initial stage,and gradually stabilized with the number of surgical cases.After the 30 cases,the average operation time,average puncture time and average radiation dose of a single vesselwere basically stable.There was no statistical significance in the difference in imaging success rate(93.3%vs.93.3%),average surgical time[(6.81±1.35)min vs.(7.57±2.64)min]and single vessel radiation dose[(108.92±9.22)mGy vs.(90.21±10.75)mGy](P>0.05).Compared with the femoral artery group,the radial artery group had significantly less postoperative recovery time[(6.46±1.40)h vs.(25.42±7.45)h],longer puncture time[(1.76±0.39)min vs.(0.84±0.23)min],smaller incidence of complications(3.3%vs.24%).The degree of anxiety and arterial sheath-related pain[(1.96±0.80),(1.59±0.57)]in the radial artery groupwere smaller than those in the femoral artery group[(4.20±1.50),(2.62±0.92)].The radial artery group had the improved
作者
李丛丛
樊保华
卢煜
张伟
孙瑞
胡月龙
Li Congcong;Fan Baohua;Lu Yu(Neurosurgery,Taihe County People's Hospital,Taihe Hospital Affiliated to Wannan Medical College,Fuyang 236600,China)
出处
《中华保健医学杂志》
2023年第3期335-338,共4页
Chinese Journal of Health Care and Medicine
基金
阜阳市自筹经费科技计划项目(FK202081078)。
关键词
脑血管造影
学期曲线
桡动脉
股动脉
Cerebral angiography
Learning curve
Radial artery
Femoral artery
