目的 评价彩超探查经桡动脉途径冠状动脉造影(transradial coronary angiography, TRA)入路的应用价值。方法 择期行经桡动脉冠状动脉造影患者400例, 随机分为术前彩色多普勒超声检查组(实验组)和非多普勒超声检查组(对照组), 各200例。主要评价指标包括造影成功率、造影时间、不同直径造影鞘管使用率、术中及术后不良事件(如死亡、急性心肌梗死、局部血肿、假性动脉瘤、骨筋膜室综合征和桡动脉闭塞);次要评价指标包括桡动脉内径、超声下入路解剖变异发生率。结果 实验组造影成功率(100%)较对照组(90%)高, 但差异无统计学意义(P＞0.05)。实验组造影时间比对照组缩短[(10.7±1.0)min vs (12.5±3.5)min, P<0.05]。实验组血管并发症发生率显著低于对照组;两组均未发生死亡、假性动脉瘤、桡动脉闭塞及骨筋膜室综合征。结论 TRA前应用彩超探查造影入路可提高造影成功率, 缩短造影时间, 减少术中桡动脉痉挛及术后局部并发症。

Objective To explore the value of Color Doppler ultrasound in examining angiography access before transradial coronary angiography(TRA). Methods Four hundred consecutive patients undergoing elective transradial cornary angiography were screened.They were randomly divided into ultrasound group (200 cases) and conventional group without ultrasound examination(200 cases).The primary endpoints included success rate, percentage of angiographic catheter use with different diameters, adverse events during and after the procedure (such as death, acute myocardial infarction, upper limb haematoma, osteofascial compartment syndrome, radial artery pseudoaneurysm or occlusion);the secondary endpoints were the average diameter of radial and anatomic variations of approach. Results The procedural success rates in the study group and conventional group were similar (100% vs 90%), procedure duration time[(10.7±1.0)min vs(12.5±3.5)min, P<0.05] were significantly low in both groups.Vascular complications in the study group was siginificantly lower than that in the conventional group (P<0.05). Conclusions Color Doppler ultrasound examining radial artery before coronary angiography raises success rate, reduces angiographic time, radial artery spasm, and local complication.