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冠心病患者桡动脉远端穿刺成功率相关危险因素分析

Analysis of the Risk Factors Related to the Success Rate of Distal Transradial Artery Access in Patients with Coronary Heart Disease.

作者信息

Li Shan-Shan, Li Jian-Ming, Liu Ling-Ling, Liu Wei, Yang Hao, Feng Chun-Guang

机构信息

Department of Cardiology, Xuzhou Central Hospital, Xuzhou, 221009, People's Republic of China.

Department of Cardiac Surgery, Xuzhou Central Hospital, Xuzhou, 221009, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2022 Apr 13;15:657-663. doi: 10.2147/RMHP.S357780. eCollection 2022.

Abstract

OBJECTIVE

The aim of this study was to explore the factors influencing the success rate of distal transradial access (dTRA) for coronary intervention.

METHODS

A total of 246 patients who underwent either coronary angiography or percutaneous coronary intervention in the Xuzhou Central Hospital were enrolled in this study. Access via the distal radial artery was the first choice for the procedure, and the success rate of this approach was recorded. All patients underwent color Doppler ultrasonography of the distal radial artery at the right anatomical snuff box in order to measure the artery diameter. The patients were divided into two groups depending on the success of the dTRA; 44 patients with unsuccessful punctures were assigned to the observation group and 202 patients with successful punctures acted as the control group. The basic clinical data of the two groups were recorded, and the differences between the two groups with respect to various indices were evaluated. Logistic regression analysis was carried out to explore the factors influencing the success rate of dTRA.

RESULTS

Of the 246 patients, dTRA was achieved in 202, giving a puncture success rate of 82.11%. Logistic regression analysis showed that the success rate of dTRA was positively correlated with the diameter of the distal radial artery (odds ratio [OR] = 3.381, = 0.005) and hypertension (OR = 2.427, = 0.016), and negatively correlated with female gender (OR = 0.429, = 0.036) and diabetes mellitus (OR = 0.325, = 0.002).

CONCLUSION

The results of this study suggest that hypertension and distal radial artery diameter have a positive effect on the success rate of dTRA, while diabetes and female gender have a negative effect.

摘要

目的

本研究旨在探讨影响冠状动脉介入治疗中经桡动脉远心端入路(dTRA)成功率的因素。

方法

本研究纳入了徐州中心医院246例行冠状动脉造影或经皮冠状动脉介入治疗的患者。该手术首选经桡动脉远心端入路,并记录该入路的成功率。所有患者均接受右手解剖鼻烟窝处桡动脉远心端的彩色多普勒超声检查,以测量动脉直径。根据dTRA是否成功将患者分为两组;44例穿刺未成功的患者被分配到观察组,202例穿刺成功的患者作为对照组。记录两组的基本临床资料,并评估两组在各项指标上的差异。进行Logistic回归分析以探讨影响dTRA成功率的因素。

结果

在246例患者中,202例成功实现了dTRA,穿刺成功率为82.11%。Logistic回归分析显示,dTRA成功率与桡动脉远心端直径呈正相关(比值比[OR]=3.381,P=0.005)和高血压呈正相关(OR=2.427,P=0.016),与女性性别呈负相关(OR=0.429,P=0.036)以及与糖尿病呈负相关(OR=0.325,P=0.002)。

结论

本研究结果表明,高血压和桡动脉远心端直径对dTRA成功率有积极影响,而糖尿病和女性性别则有负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a266/9013917/40400ea5ef11/RMHP-15-657-g0001.jpg

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