杨虹波,曹嘉添,张峰,宋亚楠,黄浙勇,李晨光,戴宇翔,钱菊英,葛均波

• 1:国家放射与治疗临床研究中心上海市心血管病研究所复旦大学附属中山医院心内科

摘要(Abstract)：

目的 分析对比合并动脉环和（或）动脉严重迂曲患者经桡动脉路径行冠状动脉造影时，导管打折的预防方法。方法 回顾性分析2015年7月至2019年7月期间完成的经桡动脉路径行冠状动脉造影合并动脉环和（或）动脉严重迂曲的720例患者的资料，根据术中是否送入0.035in(1in=2.54cm)导丝辅助旋转分为导丝预防组（372例）和对照组（348例），比较两组的临床基线资料、实验室检查结果、手术特征、导管打折发生率及处理方法。结果 两组患者临床特征、实验室检查结果比较，差异均无统计学意义（均P>0.05），两组患者经左侧桡动脉路径、首次桡动脉穿刺、术者经验<200例、动脉环和（或）动脉严重迂曲、经右侧桡动脉造影失败、并发症发生率比较，差异均无统计学意义（均P>0.05）。对照组导管打折发生率明显高于导丝预防组（1.4%比0,P=0.020）,1例发生在完成左冠状动脉造影过程中，4例发生在完成右冠状动脉造影过程中，此5例打折导管通过介入方式解除，更换导管后在0.035 in导丝辅助下完成冠状动脉造影，其中1例患者术后发生右上臂轻微肿胀，压迫后好转，顺利出院，无严重并发症发生。结论 规范操作造影导管打折的发生率低，在合并上肢动脉环、动脉严重迂曲等高危患者中，主动使用0.035 in导丝可有效预防导管打折。

关键词(KeyWords)： 经桡动脉路径;冠状动脉造影;导管打折

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（81801374）;; 上海市放射与治疗（介入治疗）临床医学研究中心项目（19MC1910300）;; 上海市“医苑新星”青年医师培养计划项目（2021-99）

作者(Author): 杨虹波,曹嘉添,张峰,宋亚楠,黄浙勇,李晨光,戴宇翔,钱菊英,葛均波

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