门诊病人经桡动脉途径行冠状动脉造影的可行性探讨.DOCVIP

287例门诊病人经桡动脉径路冠脉造影的可行性和安全性分析 李伟明 陈清勇 陈艳清 魏毅东 侯磊 王勇 李宪凯 徐亚伟 陆芸岚 杨秀琴 【摘要】 目的 探讨门诊病人经桡动脉径路进行冠状动脉造影（CAG）的可行性和安全性。方法 收集自2010年9月至2012年3月因胸闷等不适、冠脉支架术后准备复查在我院心内科门诊就诊，并签署知情同意书接受CAG的患者。即刻常规给予氯吡格雷600mg顿服，阿司匹林300mg嚼服。结果 1年半内累计有287例门诊患者在门诊当天全部顺利完成经桡动脉径路的CAG，结果发现冠状动脉重度狭窄44例，18例即刻完成冠状动脉支架术（PCI）并转住院，4例直接转入院择期PCI，2例家属拒绝PCI，5例建议冠状动脉旁路移植术；冠状动脉心肌桥68例，均直接建议药物治疗。5例（1.7%）因右桡动脉径路扭曲和/或伴痉挛更换左桡动脉完成，3例（1.0%）因穿刺右桡动脉失败改从左桡动脉完成CAG，未出现动静脉瘘及大出血。患者术后均无胸闷不适主诉，桡动脉局部平均加压包扎时间为5.2±0.4小时，7例穿刺部位有轻度血肿或水泡（2.4%），但无需特殊处理。所有患者，除转入住院外，均于压迫止血后即刻平安回家。结论 门诊病人经桡动脉径路行CAG完全可行而且十分安全。 【关键词】 经桡动脉径路；门诊病人；冠状动脉造影 Feasibility and safety of transradial coronary angiography in 287 outpatients. *Li Weiming,Chen Qingyong,Chen Yanqing,Wei Yidong,Hou Lei,Wang Yon,Li Xiankai, Xu Yawei,Lu Yunlan,Yan Xiuqin. *Department of Cardiology, Shanghai Tenth People’s Hospital of Tongji University.No 301,Yanchan middle road,Shanghai.200072,China Corresponding auther: Chen Yanqing.E-mail:chenyanq1998@ 【Abstract】 Objective To investigate the feasibility and safety of transradial coronary angiography in outpatients. Method From September 2010 to March 2012,,287 outpatients from our cardiovascular department, with precordial discomfort or with a purpose of re-examination after coronary stenting, were recruited. All the participants signed the informed consent of receiving the coronary angiography (CAG), and 600mg clopidogrel and 300 aspirin were routinely prescribed to each subject. Results Of 287 outpatients who received the transradial coronary angiography in his/her one-day visit, 44 patients had severe coronary stenosis, 18 received the percutaneous coronary intervention (PCI) immediately and transferred to the ward, 4 directly transferred to the ward for the postponed PCI, 2 refused the PCI, 5 suggested to coronary artery bypass grafting (CABG), and 68 with myocardial bridge received drug therapy, Moreover, only 5 (1.7%) and 3 (1.0%) cases were punctured on the left radial artery because of the tortuosity and/or the spasm of the right one or