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目的比较经桡动脉和经股动脉行冠状动脉造影的优缺点。方法 2006年7月-2008年9月疑诊冠心病拟行冠状动脉造影术的患者287例,随机分成经桡动脉组(185例)和经股动脉组(102例),对比观察其穿刺成功率、手术操作时间、X线曝光时间、止血包扎时间、肢体制动时间、术后住院天数和并发症的发生率。结果桡动脉组的平均X线曝光时间、穿刺成功率分别为(5.13±3.72)min和98.92%,经股动脉组为(4.78±3.51)min和100%,两组比较差异无统计学意义(P>0.05);手术操作时间分别为(19.62±3.58)min和(16.57±4.30)min,两组比较差异有统计学意义(P<0.05);经桡动脉组止血包扎时间和肢体制动时间分别为(0.72±1.15)min和4～6h,经股动脉组为(20±7.32)min和20～24h,两组比较差异有统计学意义(P<0.05);经桡动脉组的术后住院天数为(3.06±1.42)d,少于经股动脉组(4.97±3.07)d(P<0.01);两组局部血肿发生率分别为0和1.96%,差异有统计学意义(P<0.05);经桡动脉组动脉痉挛发生率为2.16%,经股动脉组无动脉痉挛发生,两组比较差异有统计学意义(P<0.05)。结论经桡动脉径路行冠状动脉造影是安全有效的方法 ,具有止血容易、不需卧床、痛苦小、并发症少和住院时间短的优点,患者更易接受。
Objective To compare the pros and cons of transradial and transthoracic coronary angiography. Methods From July 2006 to September 2008, 287 patients suspected of having coronary artery disease undergoing coronary angiography were randomly divided into transradial group (185 cases) and transsphenoidal group (102 cases), and the successful puncture was observed Rate, operation time, X-ray exposure time, hemostatic dressing time, limb immobilization time, postoperative hospitalization days and the incidence of complications. Results The mean radiographic time and puncture success rates were (5.13 ± 3.72) min and 98.92% in the radial artery group and (4.78 ± 3.51) min and 100% in the femoral artery group, respectively. There was no significant difference between the two groups P> 0.05). The operative time was (19.62 ± 3.58) min and (16.57 ± 4.30) min respectively, there was significant difference between the two groups (P <0.05) (0.72 ± 1.15) min and 4 ~ 6 h, respectively. The mean arterial pressure in the femoral artery group was (20 ± 7.32) min and 20 ~ 24h respectively. The difference between the two groups was statistically significant (P <0.05) The days of hospitalization were (3.06 ± 1.42) d less than those in the femoral artery group (4.97 ± 3.07) days (P <0.01). The incidence of local hematoma in the two groups were 0 and 1.96%, respectively, with significant difference (P <0.05 ). The incidence of arterial spasm in the transradial group was 2.16%, and no arterial spasm occurred in the femoral artery group. The difference between the two groups was statistically significant (P <0.05). Conclusions Coronary artery angiography via radial artery approach is a safe and effective method. It has the advantage of easy hemostasis, less bed rest, less pain, fewer complications and shorter hospital stay, and is more acceptable for patients.