摘要
目的:比较经右桡动脉应用Tiger I导管和左、右Judkins导管行冠状动脉造影的安全性、可行性。方法:①对象:选择2007-04/10南京医科大学附属南京第一医院心内科欲行冠状动脉造影患者200例,男123例,女77例,平均年龄(58±8)岁,随机分为2组,每组100例。患者对治疗知情同意。②方法:两组均采用经右桡动脉径路,一组用6F Judkins L(JL)3.5、Judkins R(JR)3.5造影导管(美国Cordis公司生产)作为首选导管,如大小不适合可换用6FJL4.0、JR4.0或别的造影导管;另一组用TigerI导管(日本Terumo公司生产),如左冠状动脉或右冠状动脉插管不能成功或不能满意到位均视为Tiger I导管插管失败,需换用左或右Judkins导管或别的造影导管。每例患者导管均必须满意到达左、右冠状动脉开口并能获得清晰的影像,否则计为插管失败。③评估:观察各组中左右冠状动脉造影的成功率、造影时间、曝光时间、造影剂的用量、造影术中和导管有关的并发症的发生率、导管费用。结果:①经右桡动脉用Tiger I导管行左右冠状动脉造影成功率是94%,Judkins导管成功率100%(P<0.05)。②造影时间:Judkins导管(318.3±47.9)s、Tiger I导管(318.5±49.0)s(P>0.05)。③曝光时间:Judkins导管(1.8±0.9)min、Tiger I导管(1.9±0.6)min(P>0.05)。④造影剂的用量:Judkins导管(42.6±6.4)mL、TigerI导管(34.2±5.0)mL(P<0.05)。⑤造影术中和导管有关的并发症的发生率均为0。⑥Judkins导管费用(530.4±51.2)元、Tiger I导管费用(260±0)元。⑦材料与宿主的生物相容性:采用TigerI导管与Judkins导管行冠状动脉造影的患者均未出现血小板异常、局部炎症、全身不适等反应。结论:Tiger I导管在经右桡动脉径路的冠状动脉造影中的应用是安全、可行的,未发现特殊生物相容性问题;在造影成功率方面Judkins导管优于Tiger I导管;在减少造影剂用量、降低导管费用方面Tiger I导管优于Judkins导管。
AIM： To assess the feasibility and safety of multifunction catheter of 5F Tiger Ⅰ in coronary angiography versus Judkins approach via the right radial artery.
METHODS： （1）200 patients were selected from Department of Cardiology, Nanjing First Hospital of Nanjing Medical University from April to October 2007, including 123 males and 77 females, aged （58±8） years. They were randomized into two groups （n = 100）. The informed consent was obtained from all subjects. （2）All patients underwent coronary angiography via the right radial artery using standard Judkins catheters （Cordis Corporation, Miami, U.S.） and 5F Tiger Ⅰ catheters （Terumo Corporation, Tokyo, Japan）. 6F Judkins L （JL） 3.5 and Judkins R （JR） 3.5 were used as first choice catheters in one group, if catheter tip size was not suitable, 6F JL4.0, JR4.0 and other catheters might be used. 5F Tiger Ⅰ catheter were used in the other group. If the left or right coronary artery angiography failed or did not achieve the target site, TigerⅠ catheter intubation failed and replaced by Judldns or other catheters. （3）Success rate of left and right coronary artery angiography, total procedure time, total fluoroscopic time, usage amount of contrast, incidence of complication correlating with catheter in angiography procedure, and cost of catheter were observed.
RESULTS： （1）The success rate of Tiger Ⅰ catheter in left and right coronary artery angiographies via the right radial artery was 94%, and that of Judkins catheter was 100% （P 〈 0.05）. （2）Total procedure time was （318.3±47.9） seconds in Judkins catheter group and （318.5±49.0） seconds in Tiger Ⅰ catheter group （P 〉 0.05）. （3）Total fluoroscopic time was （1.8±0.9） minutes in Judkins catheter group and （1.9±0.6） minutes in TigerⅠ catheter group （P 〉 0.05）. （4）Usage amount of contrast was （42.6±6.4） mL in Judkins catheter group and （34.2±5.0） mL in Tiger Ⅰ catheter group （P 〈 0.05）. （5） Incidence of complication correlating with catheter in angiography procedure was zero in both two groups. （6）Judkins catheters cost （530.4±51.2） yuan, and Tiger Ⅰ catheter cost （260±） yuan. （7）Biocompatibility of material and host： No platelet disorder, local inflammation or general malaise were found in any patients undergoing coronary artery angiography by Tiger Ⅰ and Judldns catheters.
CONCLUSION： Tiger Ⅰ catheter is feasible and safe in coronary angiography via the fight radial artery with no specific biocompatibility problems. Judkins catheter is better than Tiger Ⅰ catheter in the success rate of coronary angiographies, but Tiger Ⅰ catheter is superior to Judldns catheter in reducing usage amount of contrast and cost of catheters.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第9期1719-1721,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
