作者：李峰1 ，师干伟 1 ，肖建强 1 ，虞晓龙 2 ，李文华 1 ，沈丹丹 1 ，薛社亮 1 ，吴鹏 1 ，卢伟 1 ，黄浩敏 1 ，蔡高军 1

单位：

1.213017 江苏省常州市，江苏大学附属武进医院（徐州医科大学附属武进医院）心内科；2.213017 江苏省常州市，江苏大学附属武进医院（徐州医科大学附属武进医院）超声科；通信作者：蔡高军，E-mail：cgj982@126.com

Units：

1.Department of Cardiology，Wujin Hospital Affiliated to Jiangsu University（Wujin Hospital Affiliated to Xuzhou MedicalUniversity），Changzhou 213017，China；2.Department of Ultrasonography，Wujin Hospital Affiliated to Jiangsu University（Wujin Hospital Affiliated to XuzhouMedical University），Changzhou 213017，China；Corresponding author：CAI Gaojun，E-mail：cgj982@126.com

关键词：

血管成形术，气囊，冠状动脉；桡动脉；鼻烟壶；可行性研究

Keywords：

Angioplasty，balloon，coronary；Radial artery；Anatomical snuffbox；Feasibility studies

CLC：

R 541.4

DOI：

DOI：10.3969/j.issn.1008-5971.2020.01.012

Funds：

江苏青年医学人才项目（QNRC2016310）；常州市科技支撑计划（社会发展）项目（CE2019500）

摘要：

目的　分析经桡动脉远端（鼻烟壶）路径行冠状动脉介入诊疗的可行性。方法　连续选取 2019 年 9—10 月在江苏大学附属武进医院心内科住院并拟行冠状动脉介入诊疗的患者 34 例，记录其穿刺及冠状动脉介入诊疗情况。结果　本组 34 例患者中 29 例（占 85.3%）经桡动脉远端（鼻烟壶）路径行冠状动脉介入诊疗成功，平均穿刺时间为（1.8±1.9）min，平均冠状动脉介入诊疗完成时间为（34.1±20.4）min；9 例患者行支架植入术，1 例患者行药物球囊扩张术；术后 1 例患者出现右前臂轻微出血，未见穿刺点出血、假性动脉瘤、动静脉瘘、手背及手腕肿胀 / 疼痛、手指感觉异常等。5 例患者（占 14.7%）经桡动脉远端（鼻烟壶）路径行冠状动脉介入诊疗失败，其中 3 例穿刺失败、1 例穿刺成功后反复尝试但导丝不能送入桡动脉、1 例穿刺成功后置入鞘管时疼痛感明显。结论　本研究初步证实经桡动脉远端（鼻烟壶）路径行冠状动脉介入诊疗安全、可行，在国内人群中有一定推广应用价值。

Abstract：

Objective　To analyze the feasibility of coronary angiography and intervention through distal radial artery（anatomical snuffbox）. Methods　From September to October 2019，a total of 34 inpatients that ready to receive coronaryangiography and intervention through distal radial artery（anatomical snuffbox） were selected in the Department of Cardiology，Wujin Hospital Affiliated to Jiangsu University，the puncture results as well as coronary angiography and intervention resultswere recorded. Results　Of the 34 patients，29 cases（accounting for 85.3%）successfully completed the coronary angiographyand intervention，the mean puncture time was（1.8±1.9）minutes，the mean completed time of coronary angiography andintervention was（34.1±20.4）minutes；9 cases underwent stent implantation，1 case underwent drug balloon dilatation；1 case occurred slight bleeding of right forearm after operation，no one occurred puncture point bleeding，false aneurysm，arterio-venous fistula，swelling/pain of opisthenar or wrist，or finger paresthesia. A total of 5 cases（accounting for 14.7%）failed to complete the coronary angiography and intervention，including 3 cases with puncture failure，1 case with successfulpuncture but failed to put the guide wire into radial artery after repeated attempts，1 case with obvious pain when putting sheathpipe into after successful puncture. Conclusion　This study preliminarily confirms that，coronary angiography and interventionthrough distal radial artery（anatomical snuffbox）is safe and feasible，which is worthy to be popularized and applied in Chinesepopulation to some extent.

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