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目的观察经桡动脉实施冠状动脉介入治疗(percutaneous coronary intervention,PCI)的并发症发生情况、处理措施。方法观察因不稳定性心绞痛及急性心肌梗死经桡动脉行PC I的246例患者,观察有无大出血、血管及脏器损伤、局部血肿、迷走神经反射、血栓形成、假性动脉瘤、动静脉瘘等并发症发生。结果发生各种并发症18例,发生率为7.3%,其中压迫止血不当产生的出血6例,均为少量出血;穿刺点周围血肿4例,迷走神经反射3例;发生使介入操作暂时停止或减慢的桡动脉痉挛3例;一过性视力障碍者1例;假性动脉瘤1例。结论经桡动脉行PCI穿刺血管损伤并发症在临床不少见,应注意并发症的防治,术中精细、熟练操作有助于降低并发症的发生。
Objective To observe the complication and treatment of percutaneous coronary intervention (percutaneous coronary intervention) via radial artery. Methods 246 cases of unstable angina pectoris and acute myocardial infarction who underwent PCI through radial artery were observed for major bleeding, vascular and organ damage, local hematoma, vagal reflex, thrombosis, pseudoaneurysm, arteriovenous fistula Other complications occur. Results The complications occurred in 18 cases, the incidence rate was 7.3%. Among them, 6 cases of hemorrhage caused by improper hemostasis were small bleeding, 4 cases of hematoma around the puncture point and 3 cases of vagal reflex. Slow radial artery spasm in 3 cases; transient visual impairment in 1 case; 1 case of pseudoaneurysm. Conclusions The complications of percutaneous transluminal coronary angioplasty with PCI are not uncommon in clinical practice. Prevention and treatment of complications should be noted. The fine and skilled operation can help to reduce the incidence of complications.