孔杰 占大權(quán)

【摘要】 目的 觀察經(jīng)股動脈入路和經(jīng)橈動脈入路行全腦血管造影術(shù)的優(yōu)缺點(diǎn)和并發(fā)癥發(fā)生情況。方法 97例行全腦血管造影術(shù)的患者， 根據(jù)手術(shù)路徑的不同分為經(jīng)股動脈組（53例）和經(jīng)橈動脈組（44例）。經(jīng)股動脈組采用經(jīng)股動脈入路行全腦血管造影術(shù)， 經(jīng)橈動脈組采用經(jīng)橈動脈入路行全腦血管造影術(shù)。觀察比較兩組患者穿刺成功率、手術(shù)時間、手術(shù)成功率、術(shù)后并發(fā)癥（栓塞事件、穿刺處大血腫、假性動脈瘤、尿潴留）發(fā)生情況。結(jié)果 經(jīng)股動脈組穿刺成功率100.00%高于經(jīng)橈動脈組的90.91%， 差異具有統(tǒng)計學(xué)意義（P<0.05）。兩組手術(shù)時間比較， 差異無統(tǒng)計學(xué)意義（P>0.05）。經(jīng)橈動脈組手術(shù)成功率100.00%高于經(jīng)股動脈組的90.57%， 差異有統(tǒng)計學(xué)意義（P<0.05）。經(jīng)橈動脈組并發(fā)癥發(fā)生率4.55%低于經(jīng)股動脈組的18.87%， 差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 兩種手術(shù)路徑均能很好地完成全腦血管造影術(shù)， 經(jīng)股動脈入路穿刺難度較低， 易于掌握， 但并發(fā)癥較多。經(jīng)橈動脈入路并發(fā)癥較少， 但穿刺成功率較低， 對術(shù)者要求較高。

【關(guān)鍵詞】 全腦血管造影術(shù);經(jīng)股動脈入路;經(jīng)橈動脈入路

DOI：10.14163/j.cnki.11-5547/r.2020.10.009

【Abstract】 Objective ? To observe the advantages， disadvantages and occurrence of complications of the whole brain angiography through the femoral artery approach and the radial artery approach. Methods ? A total of 97 patients with total cerebral angiography were divided into femoral artery approach group （53 cases） and radial artery approach （44 cases） by different operative approaches. Femoral artery approach group received total cerebral angiography through femoral artery approach， and radial artery approach group received total cerebral angiography through radial artery approach. The success rate of puncture， operation time， surgical success rate， occurrence of postoperative complications （embolism event， large hematoma at the puncture site， pseudoaneurysm， urinary retention） between the two groups were observed and compared. Results ? The success rate of puncture 100.00% in femoral artery approach group was higher than 90.91% in radial artery approach group， and the difference was statistically significant （P<0.05）. There was no statistically significant difference in operation time between the two groups （P>0.05）. The operative success rate 100.00% in radial artery approach group was higher than 90.57% in femoral artery approach group， and the difference was statistically significant （P<0.05）. The incidence of complications 4.55% in radial artery approach group was lower than 18.87% in femoral artery approach group， and the difference was statistically significant （P<0.05）. Conclusion ? Both operative approaches can complete the whole cerebral angiography well. The femoral artery puncture is relatively difficult and easy to master， but there are many complications. The radial artery approach has fewer complications， but the success rate of puncture is lower， and the requirements for the operator are higher.

【Key words】 Total cerebral angiography; Femoral artery approach; Radial artery approach

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[收稿日期：2019-08-14]