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目的:与右桡动脉径路对比,探讨经左桡动脉途径行冠状动脉造影检查的可行性及安全性。方法:共选择2007-10至2010-03我院住院行诊断性冠状动脉造影的连续性患者908例,分成左桡动脉组(456例)和右桡动脉组(452例),所有患者均符合Allen试验阳性(桡动脉与尺动脉之间存在良好的侧支循环),使用5F或6F桡动脉专用穿刺鞘组穿刺桡动脉,使用5F左右共用型冠状动脉造影导管(TIG造影管)或Judkins型造影导管行冠状动脉造影检查,对比两组造影完成率、导丝导管交换率、X线曝光量、血管并发症和患者接受度。结果:两组908例患者行左、右桡动脉原位穿刺成功率均为99.3%。与右桡动脉组比较,左桡动脉组超滑导丝更换率、X线曝光时间降低(P<0.001),而主要表现在X线曝光时间<3 min的患者比率左桡动脉组显著高于右桡动脉组(P<0.001),X线曝光时间>6 min的患者比率左桡动脉组显著低于右桡动脉组(P<0.001),差异均有统计学意义。结论:经左桡动脉途径行冠状动脉造影检查是安全可行的,值得临床选择性应用。
OBJECTIVE: To compare the feasibility and safety of coronary artery angiography via the left radial artery with the right radial artery. Methods: A total of 908 consecutive patients with diagnostic coronary angiography in our hospital from 2007-10 to 2010-03 were divided into the left radial artery group (456 cases) and the right radial artery group (452 cases), and all patients were consistent Allen test was positive (there was a good collateral circulation between the radial artery and ulnar artery), the radial artery was punctured with 5F or 6F special needle sheath for radial artery, the common 5F coronary catheter (TIG) or Judkins Angiography catheter coronary angiography, contrast two sets of contrast rate, guide wire catheter exchange rate, X-ray exposure, vascular complications and patient acceptance. Results: The success rates of in situ puncture of left and right radial arteries in both 908 patients in both groups were 99.3%. Compared with the right radial artery group, the rate of X-ray exposure and the rate of X-ray exposure were significantly decreased in the left radial artery group (P <0.001), while the ratio in the left radial artery group was significantly higher than that in the X-ray exposure time <3 min The ratio of left radial artery group to right radial artery group (P <0.001) and X-ray exposure time> 6 min was significantly lower than that of right radial artery group (P <0.001). The differences were statistically significant. Conclusion: Coronary angiography via the left radial artery is safe and feasible, which is worthy of clinical selective application.