經橈動脈與經股動脈途徑行選擇性全腦血管造影的對比研究

[摘要] 目的 通過與經股動脈對比，探討經橈動脈途徑行全腦血管造影的可行性、安全性及優缺點。 方法 選取同期行全腦血管造影的患者125例，按入路血管分為橈動脈組（62例）和股動脈組（63例），對比其穿刺成功率、造影成功率、手術時間、并發癥發生率，并進行統計學處理。 結果 2組穿刺成功率、造影成功率比較，差異均無統計學意義（P<0.05），橈動脈組手術時間長于股動脈組（P<0.05），并發癥發生率低于股動脈組（P<0.05）。 結論 經橈動脈途徑全腦血管造影成功率高，安全可行，并發癥少且輕微，值得推廣應用。

[關鍵詞] 腦血管造影術；橈動脈；股動脈

[中圖分類號] R651.1 [文獻標識碼] A [文章編號] 2095-0616（2012）21-19-03

Comparative study of transradial and transfemoral cerebral angiography

LIAO Geng XUE Huajie HUANG Wanyun YE Haipeng JIANG Xuejun YANG Zhi

Department of Neurology，People's Hospital in Maoming City，Maoming 525000，China

[Abstract] Objective To evaluate the feasibility，efficacy and safety of a transradial approach to cerebral angiography compare to transfemoral approach. Methods The cerebral angiography was performed in 125 patients and they were divided into transradial approach group（62 cases）and transfemoral approach group（63 cases）.The success rate of procedure，the operation time and complication rate were compared， and statistical analysis was performed. Results There were no significant differences in the puncture success rate and procedure success rate between the two groups（P<0.05）.The operation time were significantly longer and the complication rate was obviously lower in transradial approach group than those in transfemoral approach group（P<0.05）. Conclusion This study suggests that transradial cerebral angiography can be performed with minimal risk of morbidity，which is worth of using generally.

[Key words] Cerebral angiography；Radial artery；Femoral artery

全腦血管造影術（DSA）是評估腦血管疾病的“金標準”。經股動脈入路插管行腦DSA檢查具有成功率高、易操作等特點，是該術式的主要入路。但該途徑卻有以下不容忽視的缺陷：（1）較多、較嚴重的穿刺點并發癥如局部血腫形成、假性動脈瘤、腹膜后血腫等；（2）需要較長時間臥床制動使患者產生嚴重不適如腰痛、尿潴留、深靜脈血栓形成等，并延長住院時間；（3）少數情況下，如主動脈瘤、夾層、雙髂股入路動脈嚴重狹窄或閉塞等，危險性大甚至不能成功；（4）椎動脈解剖變異或起始部成角較大時，經股動脈途徑操作困難；（5）術后手工壓迫止血大大增加醫護人員工作量。經橈動脈途徑由于具有安全可行、成功率高、并發癥少、患者舒適度和依從性好等優點已在介入診治冠狀動脈疾病方面得到廣泛應用。目前國內外已有少量經橈動脈途徑行選擇性全腦血管造影術報道。……