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目的探讨肱动脉穿刺在冠脉介入治疗中的一些特殊患者应用的意义以及经肱动脉行冠脉介入治疗中可行性及安全性,同时观察肱动脉穿刺行冠脉介入治疗中的成功率及并发症的情况。方法回顾分析26例肱动脉穿刺在冠脉介入治疗中介入路径选择,患者平卧位,右手掌心向上,穿刺点在肘部肱动脉分支前,选择动脉搏动最强处,先在穿刺点用利多卡因局麻,用桡动脉穿刺针取45°角穿刺进入肱动脉,送入导丝,拔除穿刺针,送入6F桡动脉血管鞘,术后拔除鞘管,压迫止血10 min,再用绷带加压包扎。6～8 h后可解开绷带,术后无须严格卧床休息。结果 26例患者均成功地进行肱动脉穿刺并完成介入手术,无一例并发症发生,肱动脉穿刺成功率为100%。结论熟悉肱动脉穿刺部位的解剖特点,掌握相应的操作技巧并对其并发症有足够的认识和处理对策的充分准备,可以减少并发症及其不良后果的发生,因此在冠脉介入治疗中,对部分桡动脉、股动脉穿刺有禁忌的患者,肱动脉穿刺的介入路径,不失为一较理想的选择。
Objective To investigate the significance of brachial artery puncture in patients with coronary artery disease and the feasibility and safety of coronary artery interventional therapy through brachial artery. At the same time, to observe the success rate and the success rate of brachial artery puncture in coronary intervention Symptoms of the situation. Methods A retrospective analysis of 26 cases of brachial artery puncture in the interventional treatment of coronary intervention path selection, the patient supine position, the right palm upward, the puncture point in front of the elbow brachial artery branch, select the strongest artery pulse, the first puncture point with Lido Cardia local anesthesia, with radial artery puncture needle into 45 ° angle into the brachial artery, into the guide wire, remove the puncture needle, into the 6F radial artery sheath, after removal of the sheath, compression hemostasis 10 min, and then bandage Pressure bandage. 6 ~ 8 h after the bandages can be untied, no need to rest strictly in bed. Results Twenty - six patients were successful in brachial artery puncture and interventional procedure. No complication occurred. The success rate of brachial artery puncture was 100%. Conclusion Familiar with the anatomic characteristics of the brachial artery puncture site, to master the appropriate operating skills and adequate understanding of its complications and adequate preparation of treatment strategies can reduce the incidence of complications and its adverse consequences, so in coronary intervention, For some radial artery, femoral artery puncture taboo patients, brachial artery puncture access path, after all, an ideal choice.