冠脉造影桡动脉穿刺部位与血管并发症的关系

目的:探讨提高冠脉造影桡动脉穿刺成功率及减少并发症的部位。方法:共640例进行经桡动脉冠脉造影的患者,被随机分为两组:(1)穿刺点距腕横纹近端2~3cm组(A组,320例);(2)穿刺点距腕横纹近端4~5 cm组(B组,320例)。比较两组的成功率、平均穿刺操作时间、桡动脉痉挛及穿刺并发症发生率。结果:B组一次性穿刺成功率较A组显著提高(92.5%∶77.8%,P0.01)。B组平均穿刺时间较A组明显缩短(2.5±0.6)min∶4.6±1.2)min,P0.01]。两组前臂血肿的发生率无明显差异,但B组桡动脉痉挛(3.75%∶8.13%)、桡动脉闭塞(0.93%∶5.0%)的比例均明显小于A组(P均0.05)。结论:距腕横纹4~5 cm进行首次桡动脉穿刺可以提高一次性穿刺成功率,节约手术时间,减少桡动脉痉挛和桡动脉闭塞的发生率。

Study about the puncturing position of radial artery in coronary Angiography

Objective： To study the suitable puncturing position of radial artery in coronary angiography （CAG）. Methods： There were 640 cases performed CAG, they were divided into two groups randomly： （1） group A （puncture position near 2-3 cm to rasceta, 320 cases）; （2） group B （puncture position near 4-5 cm to rasceta, 320 eases）, and complications of puncture were compared between two groups. Results： The successful rate of puncture in group B increased compared with group A （92.5% vs. 77.8%, P〈0. 01）, while the average time of puncture markedly decreased （2.5±0. 6） min vs. 4.6±1. 2） min, P〈0.01]. There were no significant difference in rate of cubitus hematoma between two groups （P〉0.05）, but spasm of radial artery （3.75% vs. 8.13%） and closed rate of radial artery （0.93% vs. 5.0%） in group B significantly decreased compared with those of group A. Conclusion： The position near 4-5cm to rasceta may be the suitable puncturing position in coronary angiography .