Abstract：【Objective】 To explore the value of Doppler ultrasound in examining forearm artery before trans-radial coronary intervention (TRI). 【Methods】A total of 1358 patients undergoing elective TRI were randomly divided into ultrasound group (679 cases) and control group without ultrasound examination (679 cases). The surgical operation success rate and vascular complications were observed and compared between the two groups. 【Results】There were 129 cases of forearm artery anatomical variations in ultrasound group. The mutation rate was 19.0%. Out of these 129 cases, 120 cases underwent the left radial artery approach, while 9 patients underwent with the left radial artery approach instead. The success rate of ultrasound group was 98.7% (670/679). The control group underwent conventional right radial artery approach and the success rate was 98.5% (669/679). The postoperative arteriography of the control group showed that the incidence of forearm anatomical variation was 16.49% (112/679). There was no statistically difference between the two groups (P=0.284). The incidence of complications of the ultrasound group was 8.1% (55/679) which was lower than the control group ( 10.9%, 74/679), and the difference was statistically significant (χ2=3.092,P=0.015). 【Conclusion】Examination of forearm artery by Doppler ultrasound can not only be helpful in choosing the right artery, but also reducing vascular complication effectively.
[1] 陆伟丽,苏伟平.经桡动脉与肱动脉途径行冠脉介入术后局部并发症的对比研究[J].护理实践与研究,2009,6(1):11-13. [2] 鄢飞奔.经桡动脉冠状动脉介入术180例临床分析[J].中国卫生产业,2011,8(27):96. [3] Flather M, Rhee JW, Boothroyd DB,et al. The effect of age on outcomes of coronary artery bypass surgery compared with balloonangioplasty or bare-metal stent implantation among patients with multivessel coronary disease. A collaborative analysis of individual patient data from 10 randomized trials[J].J Am Coll Cardiol,2012,60(21):2150-2157. [4] 刘惠亮,王发强.经桡动脉冠心病介入治疗[M].北京:人民军医出版社,2006: 71. [5] 董杰,谭亚萍,吴华影,等.经不同路径行冠脉介入术患者舒适度及术后并发症的比较[J].中华现代护理杂志,2010,16(30):3635-3637. [6] Yang JH, Song YB, Song PS, et al. Impact of coronary bifurcation angle on clinical outcomes after percutaneous coronary intervention in real-world practice: results from the COBIS registry[J].Cardiology,2012,122(4):216-224. [7] 张婷,黄素英,赵爱平,等.经皮冠状动脉介入术患者发生出血事件及相关因素的研究进展[J].中华现代护理杂志,2011,17(10):1228-1230. [8] 王垒,刘慧,胡永寸,等.康复治疗在急性心肌梗死经桡动脉冠状动脉介入术中的应用[J].基层医学论坛,2012,16(25):3335-3336. [9] 王小勤,梁锦标,蔡小东,等. 经桡动脉冠状动脉介入术后桡动脉闭塞的研究现状[J].实用临床医学,2012,13(11):137-139. [10] 闫振娴,周玉杰,赵迎新,等. 彩色多普勒超声评价经桡动脉介入术对桡动脉结构的影响[J].中国循环杂志,2010,25(4):255-258. [11] 夏小燕. 谈经桡动脉和股动脉途径行冠状动脉介入术的临床观察[J].中国保健营养,2012,22(5):762-763. [12] Dagenais GR, Lu J, Faxon DP,et al. Prognostic impact of the presence and absence of angina on mortality and cardiovascular outcomes in patients with type 2 diabetes and stable coronary artery disease: results from the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial[J].J Am Coll Cardiol,2013,61(7):702-711. [13] 朱晓萍,仇静波.经桡动脉行冠状动脉介入术后血肿预防的研究进展[J].中华现代护理杂志,2010,16(17):2098-2100. [14] 邓思思,王德荣,魏朝阳. 经桡动脉途径行冠状动脉介入治疗心肌梗死的临床效果观察[J].河北医药, 2016, 38(20):3095-3097. [15] 许光瑜,祝旭飞,管敏. 彩色多普勒超声评价桡动脉血管条件对自体动静脉造瘘术的临床价值[J].局解手术学杂志, 2014,23(6):615-617.
2017, Vol. 34 
