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目的比较初学者采用经肘静脉与经股静脉路径行分侧肾上腺静脉取血(AVS)的成功率及其安全性。方法 2014年8月—2015年11月间由1名初学者对连续65例原发性醛固酮增多症患者行AVS以明确其分型,分别采用经传统经典的股静脉路径(股静脉组,15例)和经肘静脉路径(肘静脉组,50例)。比较两组的AVS操作时间、左右两侧AVS成功率、X线摄片曝光时间、造影剂用量,以及肾上腺静脉血肿、外周血管穿刺相关并发症发生情况。结果两组间AVS操作时间、X线摄片曝光时间和造影剂用量的差异均无统计学意义(P值均>0.05)。肘静脉组的双侧AVS成功率和右侧AVS成功率均显著高于股静脉组(P值均<0.05),两组间左侧AVS成功率的差异无统计学意义(P>0.05)。肘静脉组有1例患者发生右侧肾上腺血肿,股静脉组无1例患者发生手术并发症,两组间并发症发生率的差异无统计学意义(P>0.05)。结论经肘静脉路径行AVS安全、可行,其右侧AVS成功率显著高于经股静脉路径,更适合于初学者,可作为经股静脉路径的替代方法。
Objective To compare the success rate and safety of adolescent adrenal vein blood collection (AVS) by elbow vein and femoral vein in beginners. Methods A total of 65 patients with primary aldosteronism were enrolled in this study from August 2014 to November 2015. A total of 65 patients with primary aldosteronism were enrolled in this study. Cases) and the elbow vein path (elbow vein group, 50 cases). AVS operation time, left and right AVS success rate, X-ray exposure time, contrast agent dosage, complications of adrenal vein hematoma and peripheral vascular puncture were compared between the two groups. Results There were no significant differences in AVS operation time, X-ray exposure time and contrast medium dosage between the two groups (P> 0.05). The success rate of bilateral AVS and right AVS in the elbow vein group were significantly higher than those in the femoral vein group (all P <0.05). There was no significant difference in the success rate of left AVS between the two groups (P> 0.05). One patient in the elbow vein group had a right adrenal hematoma. No patient in the femoral vein group had a surgical complication. There was no significant difference in the incidence of complications between the two groups (P> 0.05). Conclusions AVS via the cubital vein is safe and feasible. The success rate of AVS on the right is significantly higher than that of the femoral vein, which is more suitable for beginners and can be used as an alternative method of transvenous femoral vein.