作者：方红义，陈珂，涂胜，李妍，牛海军，董松武，江荣炎

单位：

1.安徽省亳州市人民医院心内科2.安徽省亳州市人民医院呼吸与危重症医学科3.安徽省亳州市人民医院心电图室

Units：

Department of Cardiology, People’s Hospital of Bozhou City;Department of Respiratory and Critical Care Medicine, People’s Hospital of Bozhou City;Department of Electrocardiography, People’s Hospital of Bozhou City;

关键词：

桡动脉; 冠状动脉介入手术; 对比研究;

Keywords：

Radial artery;Coronary intervention;Comparative study;

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.276

Funds：

2020年度安徽高校自然科学研究项目（KJ2020A0336）；

摘要：

目的 探讨经远端桡动脉路径与经近端桡动脉路径在冠状动脉介入手术中的应用效果。方法 选取2021年6月至2022年4月在亳州市人民医院行冠状动脉介入手术（包括单纯冠状动脉造影、支架植入术、单纯球囊扩张术等）的患者160例，采用随机数字表法分为观察组与对照组，每组80例。对照组经近端桡动脉行冠状动脉介入手术，观察组经远端桡动脉行冠状动脉介入手术。比较两组患者穿刺成功率、穿刺时疼痛评分、穿刺时间、手术时间，术后第1、2天并发症发生率，术后第3天桡动脉闭塞发生率。结果 观察组穿刺成功率为85.0%(68/80)，低于对照组的96.2%(77/80)（χ2=5.959,P=0.015）。观察组穿刺时疼痛评分高于对照组，穿刺时间长于对照组（P<0.05）。观察组术后第1天并发症发生率低于对照组（P<0.05）。结论 与经近端桡动脉路径相比，经远端桡动脉路径行冠状动脉介入手术的穿刺成功率低、穿刺时疼痛明显、穿刺时间长，但术后第1天并发症发生率低，故经远端桡动脉路径可作为经近端桡动脉路径行冠状动脉介入手术的一种备选方案，特别是对行冠状动脉旁路移植术或需要保留桡动脉的患者。

Abstract：

Objective To investigate the application effect of coronary intervention through distal radial artery access and proximal radial artery access. Methods A total of 160 patients who underwent coronary intervention（including simple coronary angiography, stent implantation, simple balloon dilation, etc.） in People’s Hospital of Bozhou City from June 2021 to April 2022 were selected. The patients were divided into observation group and control group by random number table method, 80 cases in each group. The control group underwent coronary intervention via the proximal radial artery access, while the observation group underwent coronary intervention via the distal radial artery access. The puncture success rate, pain score during puncture, puncture time, operation time, incidence of complications on the 1st and 2nd day after operation, and incidence of radial artery occlusion on the 3rd day after operation were compared between the two groups. Results The success rate of puncture in the observation group was 85.0%（68/80）, which was lower than 96.2%（77/80） in the control group（χ2=5.959, P=0.015）. The pain score during puncture in the observation group was higher than that in the control group, and the puncture time was longer than that in the control group（P < 0.05）. The incidence of complications on the first day after operation in the observation group was lower than that in the control group（P < 0.05）. Conclusion Compared with the proximal radial artery access, the puncture success rate of coronary intervention via the distal radial artery access is lower, the puncture pain is obvious, the puncture time is prolonged, but the incidence of complications on the first postoperative day is lower. Therefore, the distal radial artery access can be used as an alternative to the proximal radial artery access for coronary intervention, especially for patients undergoing coronary artery bypass grafting or requiring preservation of the radial artery.

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