Ding Jiani, Chen Xiaoyu
Department of Outpatient Service, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325005, Zhejiang, China.
Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325005, Zhejiang, China.
Emerg Med Int. 2022 May 19;2022:4105875. doi: 10.1155/2022/4105875. eCollection 2022.
To investigate the effect of different body mass indexes (BMIs) on patients' puncture pain, puncture success rate, and image quality in coronary angiography (CAG) performed with an intravenous indwelling needle, and to provide a basis for selecting the appropriate intravenous indwelling needle for CAG in patients with different BMIs in an outpatient clinic.
In this study, 300 patients undergoing CTA at the department of radiology in the First Affiliated Hospital of Wenzhou Medical University from January to May 2021 were divided into group 1 (BMI 1 ≤ 18.5), group 2 (18.5 < BMI ≤ 24), and group 3 (BMI > 24) according to their BMI, with 100 cases in each group, and a 20 G intravenous indwelling needle was used in each group. The age, sex, height, and weight of each patient were recorded, and the primary puncture success rate, contrast leakage rate, injection success rate, pain perception, and subjective ratings of image quality and objective indicators were compared in patients with different BMI values.
There was no statistically significant difference between the age, gender, and heart rate of the patients in the three groups ( > 0.05). There was no statistically significant difference between the primary puncture success rate, injection success rate, and contrast leakage rate of the three groups of patients ( > 0.05). The pain scores of group 3 during contrast injection were significantly higher than those of the remaining two groups ( < 0.05), while the differences between the pain scores of group 2 and group 1 during contrast injection were not statistically significant ( > 0.05); the comparison of the pain scores of the three groups during puncture and during retention was not statistically significant ( > 0.05). The differences between the subjective ratings of image quality and the objective indicators of the three groups were not statistically significant ( > 0.05).
The 20 G indwelling needle can basically meet the coronary angiography examination of patients with different body mass indexes, but patients with a BMI greater than 24 are recommended to use a larger diameter indwelling needle to reduce contrast leakage as well as to reduce patient pain and improve patient comfort.
探讨不同体重指数（BMI）对采用静脉留置针进行冠状动脉造影（CAG）时患者穿刺疼痛、穿刺成功率及图像质量的影响，为门诊不同BMI患者CAG选择合适的静脉留置针提供依据。
本研究选取2021年1月至5月在温州医科大学附属第一医院放射科行CTA检查的300例患者，根据BMI分为1组（BMI≤18.5）、2组（18.5＜BMI≤24）和3组（BMI＞24），每组100例，每组均采用20G静脉留置针。记录每位患者的年龄、性别、身高和体重，比较不同BMI值患者的首次穿刺成功率、造影剂渗漏率、注射成功率、疼痛感知、图像质量主观评分及客观指标。
三组患者的年龄、性别和心率比较，差异无统计学意义（P＞0.05）。三组患者的首次穿刺成功率、注射成功率和造影剂渗漏率比较，差异无统计学意义（P＞0.05）。3组患者在造影剂注射时的疼痛评分显著高于其余两组（P＜0.05），而2组和1组患者在造影剂注射时的疼痛评分差异无统计学意义（P＞0.05）；三组患者在穿刺时和留置时的疼痛评分比较，差异无统计学意义（P＞0.05）。三组患者的图像质量主观评分与客观指标差异无统计学意义（P＞0.05）。
20G留置针基本能满足不同体重指数患者的冠状动脉造影检查，但对于BMI大于24的患者，建议使用更大管径的留置针，以减少造影剂渗漏，同时减轻患者疼痛，提高患者舒适度。
