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经桡动脉心脏导管插入术后的麻木感:来自桡神经浅支神经传导研究的结果

Numbness after Transradial Cardiac Catheterization: the Results from a Nerve Conduction Study of the Superficial Radial Nerve.

作者信息

Jang Ho-Jun, Kim Ji-Young, Han Jae Deok, Lee Hyun Jong, Kim Je Sang, Park Jin Sik, Choi Rak Kyeong, Choi Young Jin, Shim Won-Heum, Kwon Sung Woo, Kim Tae-Hoon

机构信息

Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.

Department of Neurology, Inje University Seoul Paik Hospital, Seoul, Korea.

出版信息

Korean Circ J. 2016 Mar;46(2):161-8. doi: 10.4070/kcj.2016.46.2.161. Epub 2016 Mar 21.

Abstract

BACKGROUND AND OBJECTIVES

Numbness on the hand occurs infrequently after a transradial cardiac catheterization (TRC). The symptom resembles that of neuropathy. We, therefore, investigated the prevalence, the predicting factors and the presence of neurological abnormalities of numbness, using a nerve conduction study (NCS).

SUBJECTS AND METHODS

From April to December 2013, all patients who underwent a TRC were prospectively enrolled. From among these, the patients who experienced numbness on the ipsilateral hand were instructed to describe their symptoms using a visual analogue scale; subsequently, NCSs were performed on these patients.

RESULTS

Of the total 479 patients in the study sample, numbness occurred in nine (1.8%) following the procedure. The NCS was performed for eight out of the nine patients, four (50%) of which had an abnormal NCS result at the superficial radial nerve. A larger sheath and history of myocardial infarction (p=0.14 and 0.08 respectively) tended towards the occurrence of numbness; however, only the use of size 7 French sheaths was an independent predictor for the occurrence of numbness (odds ratio: 5.50, 95% confidence interval: 1.06-28.58, p=0.042). The symptoms disappeared for all patients but one, within four months.

CONCLUSION

A transient injury of the superficial radial nerve could be one reason for numbness after a TRC. A large sheath size was an independent predictor of numbness; therefore, large sized sheaths should be used with caution when performing a TRC.

摘要

背景与目的

经桡动脉心脏导管插入术(TRC)后手部麻木并不常见。该症状类似于神经病变。因此,我们使用神经传导研究(NCS)调查了麻木的发生率、预测因素以及神经学异常情况。

对象与方法

2013年4月至12月,前瞻性纳入所有接受TRC的患者。其中,指示同侧手部出现麻木的患者使用视觉模拟量表描述其症状;随后,对这些患者进行NCS检查。

结果

在研究样本的479例患者中,术后有9例(1.8%)出现麻木。9例患者中有8例进行了NCS检查,其中4例(50%)桡神经浅支的NCS结果异常。较大尺寸的鞘管和心肌梗死病史(分别为p = 0.14和0.08)有导致麻木发生的倾向;然而,仅使用7号法国鞘管是麻木发生的独立预测因素(比值比:5.50,95%置信区间:1.06 - 28.58,p = 0.042)。除1例患者外,所有患者的症状在4个月内消失。

结论

桡神经浅支的短暂损伤可能是TRC后手部麻木的原因之一。较大尺寸的鞘管是麻木的独立预测因素;因此,进行TRC时应谨慎使用大尺寸鞘管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0764/4805560/8f5718b90a3a/kcj-46-161-g001.jpg

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