经桡动脉途径冠状动脉介入治疗术后术肢血肿、肿胀的观察.pdf

《经桡动脉途径冠状动脉介入治疗术后术肢血肿、肿胀的观察.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、实用临床医学2014年第15卷第8期Prac~calClinicalMedwine．2014．Vol15．No8·17·经桡动脉途径冠状动脉介入治疗术后术肢血肿、肿胀的观察王玉宝，江宏飞，许骄阳，温红梅(1．连云港市东方医院心内科，江苏连云港222042；2．厦门市心脏中心心内科，福建厦门361004)摘要：目的总结经桡动脉途径冠状动脉介入治疗(TRI)的l临床经验。方法对42例TRI术后发生术肢血肿、肿胀患者的临床资料进行回顾性分析。结果42例患者中发生前臂血肿5例(11．9％)，其中3例由于导丝损伤小分支血管，2例由于桡动脉痉挛，拔出导管或鞘管时损伤血管内皮。术肢肿

2、胀37例(88．1％)，其中19例与术程较长、肝素用量加大，止血器压力过大、压迫时间延长有关；l2例因桡动脉血管细小、痉挛，多次、多部位穿刺．止血器压迫桡动脉鞘管穿刺点及其他穿刺点渗血引起；4例与术后患者过早活动术肢不当有关：2例与止血器压迫位置不当引起。所有TRI术后术肢血肿、肿胀患者均予以恰当处理，未发生骨筋膜间隔综合征．均康复出院。结论熟练的桡动脉穿刺技术、严格的手术操作流程及认真的术后护理能有效地预防和减少TRI术后术肢血肿、肿胀的发生。关键词：经桡动脉冠状动脉介入治疗；血肿；肿胀：肢体中图分类号：R54文献标志码：A文章编号：1009—8194(2014)08

3、—0017—02LimbHematomaandSwellingafterTransradialCoronaryInterventionWANGYu-bao1,JIANGHong-fei2,XUJiao-yang2，WENHong-mei(1．DepartmentofCardiovasology,LianyungangEastHospital，Lianyungang222042，China；2．DepartmentofCardiovasology,XiamenHeartCentre，Xiarnen361004，China)ABSTRACT：ObjectiveTosumma

4、rizeourclinicalexperiencewithtransradialcoronaryintervention(TRI)．MethodsTheclinicaldataof42patientswithlimbhematomaandswellingfollowingTR1wereanalyzedretrospectively．ResultsFiveofthe42patients(11．9％1hadforearmhematoma．Amongthem，thehematomawascausedbyguidewire——inducedsmallbranchvesselin

5、juryin3,andbyradialarteryspasmandvascularendothelialinjuryduringcatheterorsheathwithdrawalin2．Thirty-sevenofthe42patients(88．1％)hadipsilaterallimbswelling．Amongthem，theswellingwascausedbythelongeropera-tiveduration，increasedheparindosage，excessivehemostatpressureandprolongedoppressiontim

6、ein19，byradialarteryspasm，muhiplepunctures，hemostaticcompressionoftheradialarterysheathpuncturesiteanderrhysisofotherpuncturesitesin12，byearlypostoperativeactivityin4，andbyimproperhemostatoppressionpositionin2．Allpatientswithpostoperativelimbhematomaandswellingweretreatedappropriatelyand

7、dischargedfromhospitalwithouttheoccurrenceofosteofascialcompartmentsyndrome．ConclusionTheskillfulradialarterypuncturetechnique，strictsurgicalprocessandcarefulpostoperativenursingcaneffectivelypreventandreducelimbhematomaandswellingafterTRI．KEYWORDS：transradialcoronaryinte