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目的 :探讨老年病人经桡动脉途径进行冠状动脉造影术的可行性和安全性。方法 :1、对象 :10 4名病人 ,男性 80人 ,女性 2 4人 ,平均年龄 (74.2± 4.4)岁。临床诊断 :稳定性心绞痛 3 6例 (3 4.6% ) ,不稳定性心绞痛 2 2例(2 1.1% ) ,急性心肌梗死 2 7例 (2 6.0 % ) ,其它 19例 (18.3 % )。 2、方法 :(1)Allen试验 ;(2 )桡动脉穿刺 :置入 5F或 6F动脉鞘管 ;(4 )用药 :动脉鞘内注入 2 -5mg异搏啶或 2mg异舒吉 ;静脉注射肝素 5 0mg ;(5 )造影顺序 :右冠、左冠和左室造影 ;(6)造影完成后 ,立刻拨出鞘管 ,加压包扎 ,2小时后改为普通包扎。结果 :1、手术结果 :10 0例获得成功 ,成功率为 96.2 %。 4例失败的原因是 :2例因桡动脉穿刺和插管未成功 ,2例因锁骨下动脉硬化和迂曲而不能插管至冠脉开口处 ;2、造影结果 :13例冠脉正常 ,17例单支病变 ,3 3例双支病变 ,3 7例三支病变。 3、导管选择 :(1)右冠造影 :10 0例中 ,97例用Judkins右冠导管 ,2例用Amplatz右冠导管 ,1例用Amplatz左冠导管 ;(2 )左冠造影 :90例用Jud kins左冠导管 ,8例用Amplatz左冠导管 ,2例用Voda左冠导管。结论 :在老年病人经桡动脉进行冠状动脉造影是一种安全可行的介入诊断新途径 ,具有止血容易、术后无须卧床休息、病人痛苦小和并发症少等优点
Objective: To investigate the feasibility and safety of coronary artery angiography through the radial artery in elderly patients. Methods: 1. Subjects: 104 patients, 80 males and 24 females, with an average age of (74.2 ± 4.4) years. Clinical diagnosis included 36 cases of stable angina (36.6%), 22 cases of unstable angina (21.1%), 27 cases of acute myocardial infarction (26.0%) and 19 cases (18.3%) of other cases. 2, Methods: (1) Allen test; (2) radial artery puncture: placed 5F or 6F arterial sheath; (4) medication: arterial sheath injection of 2 -5mg isopiperidine or 2mg isosafli; intravenous heparin (6) angiography is completed, immediately set aside the sheath, pressure bandage, 2 hours later changed to ordinary bandage. Results: 1, surgical results: 100 cases were successful, the success rate was 96.2%. 4 cases failed due to unsuccessful radial puncture and intubation in 2 cases and 2 cases unable to intubate to the opening of coronary artery due to subclavian arteriosclerosis and tortuosity; 2, angiography results: 13 cases of normal coronary artery, 17 Cases of single-vessel disease, 33 cases of double-vessel disease, 37 cases of three lesions. 3, catheter selection: (1) right coronary angiography: 100 cases, 97 cases with Judkins right coronary catheter, 2 cases with Amplatz right coronary catheter, 1 case with Amplatz left coronary catheter; (2) left coronary angiography: 90 cases Left-coronal catheter with Jud kins, left-coronal catheter with Amplatz in 8 cases and left-coronal catheter with Voda in 2 cases. CONCLUSION: Coronary angiography via the radial artery in elderly patients is a safe and feasible new way of interventional diagnosis with the advantages of easy hemostasis, no bed rest after operation, little patient suffering and fewer complications