股动脉穿刺术临床应用和效果评价.docVIP

股动脉穿刺术临床应用和效果评价 　　[摘要] 目的 评价经皮股动脉穿刺技术的效果，以利于进一步提高股动脉前壁穿刺成功率，减少并发症的发生，提高股动脉穿刺的安全性。 方法 应用回顾性分析总结股动脉穿刺介入治疗患者1 325例的穿刺效果。所有患者均采用改良的Seldinger式穿刺介入手术方案（直接用穿刺针行股动脉前壁穿刺）。 结果 Seldinger式经股动脉穿刺介入手术一次穿刺成功率为96.3％，其中，穿刺处局部出血或血肿18例，患者均未发生假性动脉瘤、动脉夹层及盆腔血肿等严重并发症。 结论 经股动脉前壁穿刺插管是安全、便捷的有效途径，熟练掌握穿刺技术是提高手术成功率、减少各项并发症的关键因素。 　　[关键词] 股动脉；穿刺；并发症 　　[中图分类号] R459.9 [文献标识码] B [文章编号] 1673-7210（2012）01（b）-157-02 　　 　　Clinical application and effectiveness evaluation of femoral artery paracentesis 　　ZHUANG Guangyi LU Zhanxing CHEN Xinhui XIA Guoqiang ZHU Peixin 　　Department of Radiology, the Medical General Hospital of ZPNH, Henan Province, Pingdingshan 467000, China 　　[Abstract] Objective To value the effectiveness of percutaneous femoral artery paracentesis, in order to enhance the success rate of puncture, reduce the incidence of complication, enhance the security of femoral artery paracentesis. Methods Puncture effectiveness of 1 325 cases of patients who were treated with femoral artery paracentesis were summarized and analyzed retrospectively. All patients were treated with Seldinger paracentesis. Results The success rate of one time paracentesis was 96.3％. 18 cases had complications of local bleeding and hematoma in puncture place. No other serious complications happened, such as false aneurysm, dissecting aortic aneurysm, pelvic hematoma. Conclusion The way of femoral artery puncture intubation is safety and convenient. Master puncture technology expertly is the key factor to enhance the success rate of operation and reduce the incidence of complications. 　　[Key words] Femoral artery; Puncture; Complication 　　近年来介入放射学发展迅速，经动脉的介入诊断和治疗在临床上应用广泛。Seldingear股动脉穿刺插管是目前最常采用的穿刺途径，也是介入医师的基本功[1]。穿刺的成功与失败直接决定了动脉造影诊断和经动脉介入治疗的进行与否，甚至关系到手术的成败及诊疗效果。有文献报道，经股动脉径路行诊断性与治疗性介入的血管径路并发症发生率为1％~2％[2]，这不能不引起血管内介入工作者的高度重视。笔者经过多年的学习与实践，对股动脉穿刺术进行了总结、分析与探讨，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选择2008年1月~2011年6月我院经股动脉穿刺插管患者1 325例，男994例，女331例；年龄14~82岁，平均（55.0±6.8）岁；原发性肝癌650例，转移性肝癌147例，脑血管造影410例，其他118例。 　　1.2 方法 　　1.