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目的比较经左、右桡动脉两种途径行诊断性冠状动脉造影在手术成功率、X线透视时间、手术操作时间以及血管痉挛发生率等方面的差异。方法选择2003年3月至2006年10月天津医科大学总医院和喀什地区第二人民医院临床诊断为冠状动脉粥样硬化性心脏病患者580例,经桡动脉行选择性冠状动脉造影(CAG)。其中227例经右桡动脉,353例经左桡动脉进行操作。观察操作过程、选用导管数量、手术时间、X线曝光时间、造影成功率、血管并发症等方面。结果经左、右桡动脉两种途径行CAG操作,首次穿刺成功率差异无统计学意义(P>0.05);经左桡动脉较经右桡动脉选用导管数量多(P<0.05)、手术时间短(P<0.05)、X线曝光时间短(P<0.05)、造影成功率高(P<0.01);两组间血管痉挛发生率差异无统计学意义(P>0.05);术后均无桡动脉闭塞发生。结论经左桡动脉行冠状动脉造影导管控制方便,操作时间短,造影成功率高,与经右桡动脉途径操作具有同样的可行性和较少的血管并发症。
Objective To compare the differences of diagnostic coronary angiography in success rate, X-ray fluoroscopy time, operation time and vasospasm by the two ways of left and right radial artery. Methods From March 2003 to October 2006, 580 patients with coronary atherosclerotic heart disease were clinically diagnosed in Tianjin Medical University General Hospital and Kashgar People’s Second People’s Hospital. The patients underwent radial coronary artery selective coronary angiography (CAG) . Of these, 227 were treated with the right radial artery and 353 with the left radial artery. Observation of the operation process, the selection of the number of catheters, operation time, X-ray exposure time, imaging success rate, vascular complications and so on. Results There was no significant difference in the success rate of first puncture between the two approaches of left and right radial artery (P> 0.05). The number of catheters used by the left radial artery was higher than that of the right radial artery (P <0.05) (P <0.05). The X-ray exposure time was shorter (P <0.05) and angiography success rate was higher (P <0.01). There was no significant difference in the incidence of vasospasm between the two groups (P> 0.05) Radial artery occlusion occurs. Conclusions The left radial artery coronary artery catheterization convenient control, short operation time, high imaging success rate, with the right radial artery approach has the same feasibility and less vascular complications.