冠脉造影术中肱动脉穿刺的常见并发症及处理

王汝涛1 ，戴一2 ，刘毅1 ，夏陈海1 ，高超1 , 2

（1.第四军医大学西京医院心血管内科，陕西 西安，710032；2.西安高新医院心内科，陕西 西安，710075）

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摘要：

目的 探讨冠脉造影术中肱动脉穿刺的常见并发症及其处理、预防措施，以降低肱动脉穿刺并发症发生率。方法 回顾性分析2016年6月至2017年1月我院经肱动脉入路行冠脉造影出现的17例肱动脉穿刺并发症患者的临床资料，分析肱动脉穿刺常见并发症、形成原因、处理方法及预防措施。结果 17 例并发症患者中局部血肿13例，假性动脉瘤3例，正中神经损 伤1例。经相应对症处理后，所有患者均术后恢复。结论 局部血肿为肱动脉穿刺常见并发症，熟悉肱动脉解剖结构、规范肱动脉穿刺及压迫止血技术、严密动态观察患者术后患肢情况，可以降低肱动脉穿刺并发症的发生。

关键词：冠脉造影；肱动脉穿刺；并发症；处理方法

中图分类号：R541.4文献标志码：A文章编号：2096-1413(2017)32-0115-03

Common complications and correspond treatment methods of tansbrachial approach in coronary angiography
WANG Ru-tao 1, DAI Yi 2, LIU Yi 1, XIA Chen-hai 1, GAO Chao 1, 2
(1. Department of Cardiovascular Medicine, Xijing Hospital of the Fourth Military Medical University, Xi``an 710032; 2. Department of Cardiology, Xi``an Gaoxin Hospital, Xi``an 710075, China)

ABSTRACT: Objective To explore the common complications and correspond treatment methods of transbrachial approach in coronary angiography, to reduce the incidence of complications. Methods From June 2016 to January 2017, the clinical data of 17 patients with complications of tansbrachial approach in coronary angiography was retrospectively analyzed, the common complications of transbrachial approach, reasons of complications, treatments methods and prevention measures of complications were analyzed. Results Among the 17 patients with complications of tansbrachial approach in coronary angiography, there were 13 cases of local hematoma, 3 cases of femoral artery pseudoaneurysm and 1 case of median nerve injury. After the corresponding symptomatic treatment, all patients recovered. Conclusion Local hematoma is the main complications of tansbrachial approach in coronary angiography. Fully understanding the anatomical characteristics of the brachial artery, standard skills of tansbrachial approach and compression hemostasis, strictly dynamic observation of patients`` limb after surgery can reduce the complications of tansbrachial approach.
KEYWORDS: coronary angiography; tansbrachial approach; complication; treatment methods

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