| 胡广全,王晓晨,许邦龙,等.冠脉导丝联合球囊在处理冠脉介入桡动脉痉挛时的应用价值[J].安徽医药,2018,22(6):1043-1045. |
| 冠脉导丝联合球囊在处理冠脉介入桡动脉痉挛时的应用价值 |
| Application value of coronary guidewire combined with balloon in the treatment of radial artery spasm during coronary artery intervention |
| 投稿时间：2016-12-06 |
| DOI： |
| 中文关键词: 血管成形术,气囊,冠状动脉 桡动脉 导管插入术 硝酸甘油 球囊扩张术 |
| 英文关键词: Angioplasty,balloon,coronary Radial artery Catheterization Nitroglycerin Balloon dilation |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨应用冠脉导丝联合球囊在处理冠脉介入桡动脉痉挛时的有效性及安全性。 方法 将经桡动脉入径行冠脉造影或冠脉介入治疗术发生桡动脉痉挛的患者,按照随机数字表法于两种不同处理策略中随机采用一种处理策略,共计60例。导丝联合球囊组(WAB组,n=28)采用冠脉导丝联合球囊的方法处理桡动脉痉挛,完成经桡动脉入径的冠脉造影或冠脉介入治疗；药物组(Drug组,n=32)采用沿鞘管侧或造影导管、指引导管中注入硝酸甘油200 μg,等待5 min后再次行桡动脉入径行冠脉造影或冠脉介入治疗,观察两组经桡动脉入径行冠脉造影或冠脉介入治疗的成功率及并发症。 结果 (1)WAB组重度痉挛占71.4%,弥散痉挛占42.9%;Drug组重度痉挛占68.8%,弥散痉挛占40.6%;两组痉挛严重及弥散程度比较,差异无统计学意义(P>0.05)。(2)WAB组在冠脉导丝联合球囊指引下操作5F造影导管或6F指引导管通过痉挛部位,完成冠脉造影或冠脉介入治疗的成功率达92.9%,Drug组完成冠脉造影或冠脉介入治疗成功率为68.5%,两组比较差异有统计学意义(P<0.05)。(3)WAB组出现血管并发症2例(7.1%)；Drug组出现血管并发症3例(9.4%),两组比较差异无统计学意义(P>0.05)。 结论 冠脉造影或冠脉介入治疗发生桡动脉痉挛时,可尝试冠脉导丝联合球囊的方法辅助导管通过痉挛部位,以完成冠脉造影或冠脉介入治疗。该方法安全可行,尤其适合无其它血管路径可替代的患者。 |
| 英文摘要: |
| Objective To investigate the efficacy and safety of coronary guidewire combined with balloon in the treatment of radial artery spasm during coronary artery intervention. Methods Sixty cases of patients with radial artery spasm during coronary angiography or intervention were randomly assigned into two groups according to the random number table method.Group WAB (28 cases) used coronary guidewire combined with balloon instead of routine guidewire to run through the spastic radial artery.Drug group (32 cases) were given 200 μg Nitroglycerin from catheter sheath,then 5 minutes later,they underwent coronary artery angiography by using routine method again.The achievement ratio and complication of angiography or coronary intervention were observed in two groups. Results ① In group WAB,severe spasm accounted for 71.4%,diffuse spasmaccounted for 42.9%；in the drug group,severe spasm accounted for 68.8%,diffuse spasm accounted for 40.6%;there were no significant differences in spasm severity and diffuse degree between the two groups (P>0.05).② The successful rate of coronary angiography or percutaneous coronary intervention was 92.9% in WAB group under the guidance of the coronary guidewire combined with balloon,but the successful rate of coronary angiography or intervention in drug group was 68.5%;there was significant difference between the two groups (P<0.05).③There were 2 cases (7.1%) of vascular complications in WAB group,and 3 cases (9.4%) of vascular complications in drug group,and there was no significant difference between the two groups (P>0.05). Conclusions When radial arterial spasm occurs in the treatment of coronary angiography or coronary intervention,coronary guidewire combined with balloon can be used to assist the catheter to pass through the spasm area to complete coronary angiography or coronary intervention.This method is safe and feasible,and is especially suitable for patients who have no alternative vascular access. |
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