术前多普勒超声检查在经桡动脉冠状动脉介入治疗中的应用价值

目的]探讨术前多普勒超声检查在经桡动脉冠状动脉介入(TRI)治疗中的应用价值.方法]抽取择期行TRI治疗的患者1358例,随机分为超声组和对照组,每组679例,超声组根据多普勒超声结果选择桡动脉穿刺入路,对照组行常规肉眼下右桡动脉穿刺入路.观察并比较两组患者手术操作成功率和血管并发症发生率.结果]超声组术前经桡动脉多普勒超声检查显示679例患者中129例存在前臂动脉解剖变异发生率为19.00％(129/679),129例患者中仍有120例患者最终选择右侧桡动脉入路,9例患者术前更换为左侧桡动脉入路,手术总成功率为98.67％(670/679).对照组术后动脉造影结果显示,112例存在前臂动脉解剖变异发生率为16.49％(112/679),手术总成功率为98.53％(669/679).两组前臂动脉解剖变异率和手术总成功率比较差异无统计学意义(P＞0.05).超声组并发症发生率为8.1％(55/679),与对照组10.9％(74/679)比较差异有统计学意义(X2=3.092,P=0.015).结论]术前多普勒超声检查前臂桡动脉可帮助TRI选择合理的动脉入路,减少血管并发症的发生,值得临床推广应用.

Value of Doppler Ultrasound in Examining Forearm Artery before Trans-Radial Coronary Intervention

Objective]To explore the value of Doppler ultrasound in examining forearm artery before trans-radial coronary intervention (TRI).Methods]A total of 1358 patients undergoing elective TRI were randomly divided into ultrasound group (679 cases) and control group without ultrasound examination (679 cases).The surgical operation success rate and vascular complications were observed and compared between the two groups.Results]There were 129 cases of forearm artery anatomical variations in ultrasound group.The mutation rate was 19.0％.Out of these 129 cases,120 cases underwent the left radial artery approach,while 9 patients underwent with the left radial artery approach instead.The success rate of ultrasound group was 98.7％ (670/679).The control group underwent conventional right radial artery approach and the success rate was 98.5 ％ (669/679).The postoperative arteriography of the control group showed that the incidence of forearm anatomical variation was 16.49 ％ (112/679).There was no statistically difference between the two groups (P =0.284).The incidence of complications of the ultrasound group was 8.1％ (55/679) which was lower than the control group (10.9 ％,74/679),and the difference was statistically significant (X2 =3.092,P =0.015).Conclusion]Examination of forearm artery by Doppler ultrasound can not only be helpful in choosing the right artery,but also reducing vascular complication effectively.