Conte L, Dutto M, Dutto S, Giachello G, Lice G, Tomatis M, Russo P, Dellavalle A, Ribichini F, Steffenino G
Divisione di Cardiologia, Azienda Ospedaliera Santa Croce e Carle, Cuneo.
G Ital Cardiol. 1999 May;29(5):529-32.
The use of small catheters for cardiac catheterization, as well as for other diagnostic and interventional procedures, can reduce iatrogenic trauma on cardiac and vascular structures. Early patient mobilization may thus reduce both patient discomfort and the length and cost of stays. The performance of 4 French catheters was evaluated in a pilot cohort of consecutive in patients who underwent coronary arteriography with the use of the femoral Judkins technique and who had no restriction to full ambulation. Patients were helped to resume full ambulation two hours after the procedure, and the femoral access site was inspected 24 hours later upon discharge. Coronary arteriography with 4 French catheters was performed in 45 patients (10 women) aged 62 +/- 10 years. In one patient with anomalous origin of the right coronary artery, selective catheterization of the coronary ostium required a catheter style available only in 5 French. In all cases, selective opacification with 4 French catheters was adequate for diagnosis. Forty-three patients were mobilized 115 +/- 10 minutes after the end of manual compression. Hematoma, bleeding or limb perfusion disturbances were absent in all cases upon inspection 22 +/- 4 hours later. This pilot experience indicates that coronary arteriography with femoral 4 French Judkins catheters is technically feasible and that patient ambulation 2 hours later is safe. This data requires confirmation in a larger patient cohort and can lead to new standards for both patient comfort and the use of hospital resources in coronary arteriography.
使用小导管进行心导管插入术以及其他诊断和介入操作,可减少对心脏和血管结构的医源性创伤。因此,早期让患者活动可减轻患者不适,并缩短住院时间和降低住院费用。在一组连续的住院患者中对4法式导管的性能进行了评估,这些患者采用股动脉Judkins技术进行冠状动脉造影,且对完全行走无限制。术后两小时帮助患者恢复完全行走,出院时于24小时后检查股动脉穿刺部位。45例(10名女性)年龄为62±10岁的患者接受了4法式导管冠状动脉造影。在1例右冠状动脉起源异常的患者中,冠状动脉开口的选择性导管插入术需要使用仅5法式才有型号的导管。在所有病例中,4法式导管的选择性显影足以用于诊断。43例患者在手动压迫结束后115±10分钟开始活动。22±4小时后检查时所有病例均未出现血肿、出血或肢体灌注障碍。这一初步经验表明,使用股动脉4法式Judkins导管进行冠状动脉造影在技术上是可行的,且术后两小时让患者活动是安全的。这一数据需要在更大的患者队列中得到证实,并可能为冠状动脉造影中患者舒适度及医院资源利用带来新的标准。