经桡动脉置管后动脉内硝酸甘油(手术后,止血前)减少桡动脉闭塞的作用:一项多普勒引导的研究。

Mymensingh medical journal : MMJ Pub Date : 2023-04-01
M K Islam, M J Uddin, A Momen, T A Chowdhury, N K Dey, M A Rahman, A Mamun, M M Hasan, S K Bagchi, M Hasan, A H Jafar
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引用次数: 0

摘要

该研究旨在评估经桡动脉手术结束时通过动脉鞘注入硝酸甘油以保持桡动脉通畅的疗效。这项前瞻性观察性研究于2017年5月至2018年4月在孟加拉国达卡国家心血管疾病研究所(NICVD)心内科完成,共纳入200名通过TRA接受冠状动脉手术(CAG和/或PCI)的患者。在多普勒研究中,RAO被定义为没有顺行流或单相流或逆流。在这项研究中,102例患者(第一组)在经桡动脉鞘切除前接受200 mcg动脉内硝酸甘油。另有98例患者(II组)在经桡动脉鞘切除前未接受动脉内硝酸甘油治疗。两组患者均采用常规止血压缩方法(平均2小时)。术后第2天采用彩色多普勒测量两组患者桡动脉血流。本研究结果显示,经桡动脉冠状动脉手术后1天桡动脉闭塞率为13.5%。我们发现I组和II组的发生率分别为8.8%和18.4% (p=0.04)。术后硝酸甘油组RAO发生率明显降低。多因素logistic回归分析糖尿病患者(p = 0.02),脱鞘后止血压迫时间超过02小时(p = 0.05)
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Role of Intra-arterial Nitroglycerin (Post Procedural, Prehemostasis) to Reduce Radial Artery Occlusion after Transradial Catheterisation: A Doppler-guided Study.

The study was intended to evaluate efficacy of Intra-arterial nitroglycerin through the sheath at the end of a transradial procedure to preserve the patency of the radial artery. This prospective observational study was done in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from May 2017 to April 2018, by including a total 200 patients undergoing coronary procedures (CAG and / or PCI) through TRA. RAO was defined as an absence of antegrade flow or monophasic flow or invert flow on Doppler study. In this study 102 patients (Group I) received 200 mcg intra-arterial nitroglycerine, prior to trans-radial sheath removal. Another 98 patients (Group II) did not receive intra-arterial nitroglycerine prior to trans-radial sheath removal. Conventional haemostatic compression methods were applied (average 2 hours) in both groups of patients. Evaluation of radial arterial arterial blood flow by colour Doppler study was done on next day after the procedure in both groups. Results of this study in which RAO was determined by vascular doppler study showed that frequency of radial artery occlusion were 13.5% one day after transradial coronary procedures. We found the incidence was 8.8% vs. 18.4%, (p=0.04) in Group I and Group II respectively. The incidence of RAO was significantly lower in post procedural nitroglycerine group. From multivariate logistic regression analysis diabetes mellitus (p = 0.02), hemostatic compression time for more than 02 hours after sheath removal (p = <0.001) and procedure time (p = 0.02) was predictors of RAO. So, the administration of nitroglycerin at the end of a transradial catheterization reduced the incidence of RAO, as shown by 1 day after the radial procedure by doppler ultrasound.

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