姜杉,惠永明,张骥,熊永红,李群,李杰,于凝

• 1:北京丰台医院心内科

摘要(Abstract)：

目的与经右侧桡动脉途径相比较探讨经左侧桡动脉进行冠脉介入术的优势。方法 956例患者分别经左侧桡动脉途径(A组,558例)和右侧桡动脉途径(B组,398例)进行冠脉造影及经皮冠状动脉介入术(PCI),观察分析两组的成功率、失败原因以及导管应用类型和到位时间。结果在造影成功率上经左侧和右侧桡动脉途径差异无统计学意义(91.2%比89.4%,χ2=5.375,P=0.251);在PCI成功率上两组统计学差异无统计学意义(42.8%比49.2%,χ2=3.384,P=0.066)。在造影失败的原因中,在锁骨下动脉迂曲及头臂干迂曲钙化/闭塞不能通过的发生率在右侧桡动脉途径更高(45.2%),并且为经右侧桡动脉造影失败的最主要原因;在PCI中,指引导管一次到位成功(92.2%比74.9%,χ2=22.272,P=0.0002)或更换指引导管后成功(6.0%比18.3%,χ2=14.537,P=0.0001)以及桡动脉途径失败需要改为股动脉途径在B组中发生率更高(1.8%比6.9%,χ2=6.629,P=0.012)。在两组中JudkinsL3.5(79.2%比81.7%,χ2=0.87,P=0.351)和R3.5(78.2%比80.3%,χ2=0.582,P=0.445)的应用率最高。在穿刺-鞘管到位时间上两组比较差异无统计学意义(92.29±20.73)s比(96.16±21.13)s,t=1.04,P=0.253,但在导管到位时间上A组较B组差异有统计学意义。结论经左侧桡动脉途径进行冠脉介入术和右侧相比有一定的优势。克服操作距离大、穿刺困难的因素,左侧桡动脉值得推广。

关键词(KeyWords)： 桡动脉;冠状血管造影术;血管成形术,经腔,经皮冠状动脉

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 姜杉,惠永明,张骥,熊永红,李群,李杰,于凝

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