经桡动脉同时行冠状动脉及肾动脉造影可行性探析.docVIP

经桡动脉同时行冠状动脉及肾动脉造影可行性探析中图分类号：R543 文献标识码 ：A 文章编号：1009_816X(2011)06_0423_03 DOI:10.3969/j.issn.1009_816X.2011.06.03Combined Coronary and Renal Artery Angiography Throught Transradial A pproch. CHEN Xiao_shu, WANG Yi, JIANG Wen_bing, et al. Department of Cardiology, the T hird Hospital of Wenzhou, Zhejiang 325000, China ［Abstract］ Objective To investigate the feasibility and safety of Combined coronary and renal artery angiography throught left or right transr adial approch. Methods 120 cases of patients were randomly divided into left r adial group(52 cas es) and right radial group(68 cases) by intervention approach and undertwent com bined coronary and renal artery angiography with lengthening Judkins catheter (C ordis,125cm). The operating time,dosage of contrast agent, duration of X_ray flu oroscopy, the success rate and complications were compared statistically betwee n the two groups. Results The operating time and duration of X_ray fluoroscopy w as lower in left radial group than right radial group (P0.01、P0.05) .There is no statistical difference in the dosage of contrast agent and success rate and complication rate between the two groups . Conclusions By left radial artery approa ch combined coronary and renal artery angiography is feasible and safe and it ca n be selected as a preferential intervention approach under such clinical circum stances. ［Key words］ Radial artery； Coronary angiography； Renal angio graphy； Judkins catheter 近年来经桡动脉途径行冠状动脉造影和介入治疗普遍开展,尤其经右桡动脉途径，操作方便 ，易为患者接受，最为常用。但临床常用的TIG共用导管及Judkins造影导管，常因导管长度 不够而不适宜经桡动脉途径行肾动脉造影，本文旨在应用加长的Judkins冠状动脉造影导 管对经左或右桡动脉途径同时行选择性冠状动脉和肾动脉造影进行对比分析，从而为临床介 入诊断径路的选择提供参考 1 资料与方法 1.1 一般资料：2009年1月至2011年5月我院初步诊断为冠心病合并高血压需行选择性冠状 动脉和肾动脉造影进一步明确诊断的患者共120例，男72例，女48例，其中33例合并糖尿病 。年龄49～89（69.46±8.70）岁。按介入途径随机分为左桡动脉组（52例）和右桡动脉 组（68例），两组患者一般状况如年龄、性别构成和身高等的比较差异均无统计学意义，全 部病例Allen试验结果均为阳性 1.2 方法：患者平卧位，穿刺侧上肢伸直外展置于血管造影机的臂托上，常规消毒铺巾， 1%利多卡因局部麻醉，用Terumo桡动脉穿刺针Seldinger法穿刺桡动脉，置入6F Terumo桡动 脉鞘，经鞘内缓慢推注硝酸甘油0.2mg和肝素25mg 在X线透视