摘要
目的比较75岁及以上老年人桡动脉穿刺在神经介入手术中应用的安全性。方法单中心回顾性研究,选择2022年6—12月在首都医科大学附属北京天坛医院接受神经介入治疗的75岁及以上老年患者350例,按照穿刺方式分为股动脉穿刺及桡动脉穿刺两组,比较两组患者的安全性指标,包括是否穿刺失败、更改穿刺部位、一般穿刺并发症(包括皮下出血、穿刺点血肿、血管痉挛)、严重穿刺并发症(包括肢体远端缺血、假性动脉瘤)、下肢静脉血栓。采用多因素Logistic回归分析比较不同穿刺方法对并发症发生情况的影响。结果350例患者中280例采用股动脉穿刺、70例采用桡动脉穿刺,两组患者的基线特征差异均无统计学意义(均P>0.05)。两组患者术前应用抗血小板药物的比例、穿刺失败率、更改穿刺部位率、严重并发症(包括肢体远端缺血、假性动脉瘤)发生率差异均无统计学意义(χ2=2.051、0.075、0.588、3.175,P=0.152、0.784、0.443、0.075)。在股动脉穿刺组中有20.4%(57例)的患者出现了一般穿刺并发症(包括皮下出血、穿刺点血肿、血管痉挛);而在桡动脉穿刺组中仅8.6%(6例)的患者出现了一般穿刺并发症,两组差异有统计学意义(χ^(2)=5.720,P=0.022)。多因素Logistic回归分析结果显示,与股动脉穿刺比较,桡动脉穿刺能减少所有并发症(OR=0.272,95%CI:0.139~0.532,P<0.001)、一般穿刺并发症(OR=0.375,95%CI:0.153~0.919,P=0.032)、下肢静脉血栓(OR=0.219,95%CI:0.050~0.954,P=0.043)的发生风险。结论在接受神经介入术的75岁及以上的老年患者中,桡动脉穿刺的一般穿刺并发症和下肢静脉血栓的发生率较股动脉穿刺低,具有较好的安全性。
Objective To compare the safety of radial artery puncture in elderly patients aged 75 years and older who are undergoing neurointerventional procedures.Methods A single-center retrospective study was conducted,involving 350 elderly patients aged 75 years and older who received neurointerventional treatment at Beijing Tiantan Hospital,Capital Medical University,from June to December 2022.The participants were divided into two groups based on the puncture site:femoral artery puncture and radial artery puncture.The safety indicators compared between the two groups included puncture failure,changes in puncture site,general puncture complications(such as subcutaneous bleeding,puncture site hematoma,and vasospasm),severe puncture complications(including distal limb ischemia and pseudoaneurysm),and lower limb venous thrombosis.Multivariate Logistic regression analysis was conducted to evaluate the impact of different puncture methods on the occurrence of complications.Results Among the 350 patients,280 underwent femoral artery puncture,while 70 underwent radial artery puncture.There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The proportions of patients using antiplatelet drugs prior to surgery,puncture failure rates,rates of change in puncture sites,and the incidence of severe complications-including distal limb ischemia and pseudoaneurysm-were not significantly different between the two groups(χ^(2)=2.051,0.075,0.588,3.175;P=0.152,0.784,0.443,0.075).In the femoral artery puncture group,20.4%(57 cases)of patients experienced general puncture complications(including subcutaneous bleeding,puncture site hematoma,and vasospasm),whereas only 8.6%(6 cases)in the radial artery puncture group experienced such complications,revealing a statistically significant difference between the two groups(χ^(2)=5.720,P=0.022).Multivariate Logistic regression analysis indicated that,compared to femoral artery puncture,radial artery puncture was associated with a reduced ris
作者
李秋菊
庞珂
陈翰林
殷悦
高峰
孙瑄
宋立刚
马宁
莫大鹏
邓一鸣
缪中荣
Li Qiuju;Pang Ke;Chen Hanlin;Yin Yue;Gao Feng;Sun Xuan;Song Ligang;Ma Ning;Mo Dapeng;Deng Yiming;Miao Zhongrong(Department of Interventional Neurology,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China;Department of Nursing,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China;National Clinical Research Center of Nervous System Diseases,Beijing 100070,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2024年第10期1255-1259,共5页
Chinese Journal of Geriatrics
基金
国家自然科学基金面上项目(82171562)
国家卫生健康委能力建设和继续教育中心神经介入2023年度课题(GWJJ2023100103)。
关键词
脑血管疾病
并发症
神经介入术
桡动脉穿刺
Cerebrovasclular disease
Complication
Neurointervention
Radial arterypuncture
