资源描述：
《经桡动脉介入诊疗中桡动脉痉挛发生、预防及机制的研究》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、经桡动脉介入诊疗中桡动脉痉挛发生、预防及机制的研究导师：周玉杰教授首都医科大学附属北京安贞医院研究生：贾德安StudyontheIncidence,PreventionandMechanismofRadialArterySpasmduringTransradialProcedurePartI:IncidenceandPredictorsofRadialArterySpasmduringTransradialCoronaryAngiographyandInterventionPartII:Prospective,RandomizedandDouble-
2、blindStudyonPreventionofRadialArterySpasmPartIII:MatchedCase-ControlStudyonMechanismofRadialArterySpasm2ObjectsRadialarteryspasm(RAS)isthemostcommoncomplicationintransradialcoronaryangiographyandintervention.Inthisstudy,wedesignedtoinvestigatetheincidenceofRASduringtransradialp
3、roceduresinChinese,findouttheindependentpredictors,andanalyzetheclinicaleffectofRASduringfollow-up.Thesecondpartofthestudyweretocomparethepreventiveeffectofverapamil200μg,verapamil1mgandacocktail(verapamil200μgplusnitroglycerin200μg),andfindouttheoptimizedstrategyforthepreventi
4、onofRAS.Thisstudyalsopreliminarilydiscussedtherelationshipbetweenvaso-activesubstancesandRAS,findoutthemechanismofRAS,andprovidetheoreticevidenceforthepreventionofRAS.3ConclusionsTheoveralincidenceofRASis7.8%andfemale,smallradialarterydiameter,diabetesandunsuccessfulaccessatfir
5、stattemptweretheindependentpredictorsofRAS.Routineultrasonographyofforearmarteriesbeforetheprocedurecanexcludeseverevariationofradialartery,effectivelyavoidRASandimprovethesuccessrate.InthepreventionofRAS,itissuggestedtouseverapamil200μgplusnitroglycerin200μgtopreventRASintrans
6、radialcoronaryprocedure.Amongthevaso-activesubstances,endothelin-1andnorepinephrineweretheriskfactorsofRASduringtheprocedure.41234研究背景和方法第一部分桡动脉痉挛的发生率及预测因素第三部分桡动脉痉挛机制的配对病例对照研究第二部分预防桡动脉痉挛的随机双盲研究5研究背景TRI的优势血管并发症少穿刺点远离躯干减少心理恐惧感术后无需卧床制动减轻患者痛苦PCI后即刻拔鞘术后管理简便PCI“门诊化”缩短住院时间医方患方TRI已经成为心
7、脏介入诊疗的常规路径！KiemeneijFetal.JACC.1997,29,12696712345桡动脉痉挛是经桡动脉介入诊疗最为常见的并发症术者经验和水平不同，痉挛发生率不同痉挛判断标准不一致：主观、客观各有优缺点有必要研究桡动脉痉挛的发生率和预测因素预防重于治疗，不同中心使用抗痉挛药物相差较大研究背景6探讨适合预防国人桡动脉痉挛的方法8StructureofradialarteryTypeⅢarteryIntima:endotheliumMedia:(500μm)SMCconcentriclayersAdventitiaAttaranS,eta
8、l.AnnThoracSurg.2008;85(4):1483-9.Innervation:Sympathe
