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目的:探讨经桡动脉介入诊治过程中桡动脉痉挛的发生率,评估盐酸法舒地尔对解除顽固性严重桡动脉痉挛的有效性和安全性。方法:回顾性分析2007-01-2008-11月在我院接受经桡动脉介入诊治病例共516例,以改良的Seldinger法行右桡动脉穿刺,成功置入鞘管后常规于鞘管内弹丸式注入硝酸甘油200μg、维拉帕米2.5mg、普通肝素2000U。选用5F共用型造影导管行冠状动脉造影。根据桡动脉痉挛程度分为轻度、中度、重度、顽固性4类。对于顽固性桡动脉痉挛者给予导管内弹丸式推注盐酸法舒地尔5mg,观察桡动脉痉挛解除时间,记录推注前后血压、心率,并观察有无头痛、消化系统和过敏等不良反应。结果:5.2%(27/516例)患者发生桡动脉痉挛,其中轻度8例、中度11例、重度4例、顽固性4例。顽固性桡动脉痉挛者在推注5mg盐酸法舒地尔后5min内均迅速解除痉挛,成功拔除导管和血管鞘。推注盐酸法舒地尔前后血压、心率均差异无统计学意义,未发现不良反应。结论:盐酸法舒地尔可有效迅速缓解顽固性严重桡动脉痉挛。
OBJECTIVE: To investigate the incidence of radial artery spasm during the diagnosis and treatment of radial artery and assess the effectiveness and safety of Fasudil Hydrochloride in relieving refractory and severe radial artery spasm. Methods: A total of 516 patients who underwent transradial interventional therapy in our hospital from January 2007 to November 2008 were retrospectively analyzed. The modified Seldinger ’s method was used to puncture the right radial artery. Nitroglycerin 200μg, verapamil 2.5mg, unfractionated heparin 2000U were injected. Selection of 5F common type catheter coronary angiography. According to the degree of radial artery spasm into mild, moderate, severe, intractable 4 categories. For intractable radial artery spasm were given catheter bolus bolus fasudil hydrochloride 5mg observed radial artery spasm lifting time, before and after the injection of blood pressure, heart rate, and to observe whether the headache, digestive system and allergic reactions. Results: Radial artery spasm occurred in 5.2% (27/516 cases) of patients, with mild in 8 cases, moderate in 11 cases, severe in 4 cases and intractable in 4 cases. Persistent radial artery spasm were quickly relieved spasm 5min after 5mg fasudil hydrochloride injection, the successful removal of the catheter and vascular sheath. Blood pressure and heart rate before and after bolus injection of fasudil hydrochloride were not significantly different, no adverse reactions were found. Conclusion: fasudil hydrochloride can effectively and quickly relieve refractory and severe radial artery spasm.