文章摘要
陈超,朱壹明,孙俊龙,等.影响远端桡动脉穿刺成功率相关因素分析[J].浙江中医药大学学报,2021,(1):28-33.
影响远端桡动脉穿刺成功率相关因素分析
Analysis of the Factors Influencing the Success Rate of Distal Radial Artery Puncture
投稿时间:2020-05-31  
DOI:10.16466/j.issn1005-5509.2021.01.005
中文关键词: 远端桡动脉  彩色多普勒  内径  穿刺成功率  冠状动脉粥样硬化性心脏病  回归分析
英文关键词: distal radial artery  color Doppler  internal diameter  success rate of puncture  coronary atherosclerotic heart disease  regression analysis
基金项目:浙江省中医药十三五重点学科(2017-XK-A14)
作者单位E-mail
陈超 浙江中医药大学附属第二医院 杭州 310005  
朱壹明 浙江中医药大学  
孙俊龙 浙江中医药大学  
黄抒伟 浙江中医药大学附属第二医院 杭州 310005 1123135969@qq.com 
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中文摘要:
      [目的]了解中国人群远端桡动脉内径特点,探讨远端桡动脉穿刺成功率的影响因素。[方法]入选2018年12月至2019年12月疑似冠状动脉粥样硬化性心脏病,于浙江中医药大学附属第二医院住院行冠状动脉造影检查的患者187例,术前行右手“鼻烟壶”部远端桡动脉彩色多普勒超声检查,术中首选远端桡动脉穿刺,次选桡动脉穿刺,记录远端桡动脉穿刺成功率。采用Logistic回归分析探讨远端桡动脉成功率的影响因素。[结果]187例患者中,远端桡动脉入径160例,穿刺成功率为85.56%;入选人群远端桡动脉内径总体呈正态分布,72.73%的患者远端桡动脉内径大于6F动脉鞘管外径,19.25%的远端桡动脉内径大于7F动脉鞘管外径。Logistic回归分析提示远端桡动脉穿刺成功率与远端桡动脉内径呈正相关(OR=21.137,P=0.003),与既往远端桡动脉穿刺史(OR=0.057,P=0.003)、年龄(OR=0.076,P=0.039)、肌酐水平(OR=0.120,P=0.026)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平(OR=0.076,P=0.039)、合并心房颤动(OR=0.023,P=0.010)呈负相关。[结论]远端桡动脉较常规桡动脉内径有所减少,但基本适合6F动脉鞘管;术前行远端桡动脉B超检查了解远端桡动脉内径,根据B超结果选择合适人群,可以提高穿刺成功率;既往远端桡动脉穿刺史、高龄、肌酐和LDL-C水平升高、合并心房颤动会降低远端桡动脉穿刺成功率。
英文摘要:
      [Objective]To investigate the characteristics of the diameter of the distal radial artery in Chinese population and to explore the influencing factors of the success rate of distal radial artery puncture.[Methods]One hundred and eighty-seven patients suspected of coronary atherosclerotic heart disease from December 2018 to December 2019 were selected for coronary angiography. Before the operation, the distal radial artery in the right "snuff bottle" was examined by color Doppler ultrasound. During the operation, the distal radial artery puncture was the first choice, the radial artery puncture was the second choice. Logistic regression analysis was used to explore the influencing factors of success rate of distal radial artery.[Results] Among 187 cases, the distal radial approach had 160 cases, and the success rate of puncture was 85.56%; the diameter of distal radial artery in the selected population was generally normal distribution, 72.73% of distal radial artery diameter was larger than 6F artery sheath diameter, 19.25% of distal radial artery diameter was larger than 7F artery sheath diameter. Logistic regression analysis indicated that the success rate of distal radial artery puncture and the diameter of distal radial artery were in positive correlation(OR=21.137, P=0.003); the success rate of distal radial artery puncture was negatively correlated with the past history of distal radial artery puncture(OR=0.057, P=0.003), age(OR=0.076, P=0.039), creatinine level(OR=0.120, P=0.026), low-density lipoprotein cholesterol(LDL-C) level(OR=0.076, P=0.039) and atrial fibrillation(OR=0.023, P=0.010). [Conclusion]Although the diameter of the distal radial artery is smaller than the radial artery, it is basically suitable for the 6F artery sheath. B ultrasonic examination of the distal radial artery before operation can improve the success rate of the distal radial artery puncture. The past history of distal radial artery puncture, age, creatinine, LDL-C and atrial fibrillation are negatively correlated with the success rate of distal radial artery puncture.
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