共用型造影导管在经桡动脉行冠状动脉造影的应用

目的探讨使用4F、5F共用型导管经桡动脉径路冠状动脉造影的可行性。方法入选2004年11月至2005年6月，在我院行择期经桡动脉径路冠状动脉造影65例患者，术前给予阿司匹林、波立维等抗血小板药物。并进行Allen试验，穿刺右侧桡动脉。选择Temm04F、5F共用型造影管，当使用共用型造影管难以完成时换用Judkins造影导管。结果64例患者经桡动脉穿刺成功，成功率98．4％，1例改为肱动脉穿刺成功。冠状动脉造影正常18例，冠状动脉造影异常48例，行冠状动脉介入治疗19例。结论经桡动脉行冠状动脉造影，使用共用型导管操作较简单，节省时间，较易进入左冠状动脉口，造影成功率高，本组不论选择4F或5F共用型造影导管均顺利完成左冠状动脉造影，但使用其做右冠状动脉造影需要一定经验和技巧。若难以完成时核用JudkinsR型造影导管，本组未发生桡动脉痉挛现象。1例出现前臂血肿，未经特殊处理，自行吸收，2例加压不当，引起手部浮肿。总之，使用共用型造影管经桡动脉径路冠状动脉造影，操作简便快速，病人痛苦少，安全有效，成功率高，值得临床推广应用。

Application of Communal Catheter Passing Radial artery in Coronary Angiography

Objective To ascertain the safety and efficacy of using 4F,SF communal catheters passing radial artery in coronary angiograph. Methods From November 2004 to Aprial 2005, a total of 65 patients were treated using communal catheters passing the radial artery in coronary angiography. Before liberation, they were administered Asprin , Boliwei and some antihematoblast medicin , undergoing Allen test with right radial artery punctured. The coronary angiograph goes by using Tervmo 4F,SF communal catheters passing radial artery . When communal catheters couldnt work , they were replaced by Judkins catheters. Results 64 cases were successfully punctured passing radial artery. The successful rate is 98.4% . One case was successfully punctured by passing shoulder artery instead. 18 cases were normaland 4 cases were abnormal in the coronary angiography, 19cases were treated with coronary involved. Conclusions The application of communal catheters passing radial artery in coronary angiograph is safe and effective, the operation of which is simple , using less time, easily entering the left coronary . The successful angiographyrate is high, Whether using 4F or 5F commualcatheters , the left coronary angiography can be completed smoothly. However, the fight coronary angiography needs certain experience and skills . If it is done with difficulty , Judkins R angiography catheters can be used instead . No radial artery spasm was found in the operation. One case had forearm hematoma, which can be absorbered itself without special treatment . Two cases had hand hematoma which was caused by unsuitable pressure. In a word , the operation of the method is simple and fast , during which the patients suffered less . The application can be widely used for its salty and high successful angiography rate.