经肘静脉与股静脉路径行肾上腺静脉取血的效果比较

发布时间：2018-03-24 13:10

本文选题：肾上腺静脉取血　切入点：肘静脉路径　出处：《上海医学》2017年04期

【摘要】：目的比较初学者采用经肘静脉与经股静脉路径行分侧肾上腺静脉取血(AVS)的成功率及其安全性。方法 2014年8月—2015年11月间由1名初学者对连续65例原发性醛固酮增多症患者行AVS以明确其分型,分别采用经传统经典的股静脉路径(股静脉组,15例)和经肘静脉路径(肘静脉组,50例)。比较两组的AVS操作时间、左右两侧AVS成功率、X线摄片曝光时间、造影剂用量,以及肾上腺静脉血肿、外周血管穿刺相关并发症发生情况。结果两组间AVS操作时间、X线摄片曝光时间和造影剂用量的差异均无统计学意义(P值均0.05)。肘静脉组的双侧AVS成功率和右侧AVS成功率均显著高于股静脉组(P值均0.05),两组间左侧AVS成功率的差异无统计学意义(P0.05)。肘静脉组有1例患者发生右侧肾上腺血肿,股静脉组无1例患者发生手术并发症,两组间并发症发生率的差异无统计学意义(P0.05)。结论经肘静脉路径行AVS安全、可行,其右侧AVS成功率显著高于经股静脉路径,更适合于初学者,可作为经股静脉路径的替代方法。
[Abstract]:Objective to compare the success rate and safety of AVSs for beginners with AVSs via cubital vein and femoral vein. Methods from August 2014 to November 2015, 65 consecutive cases of primary aldosterone were selected from one beginner. Patients with polyplasia were given AVS to determine their typing. Traditional femoral vein pathway (femoral vein group, 15 cases) and cubital vein pathway (50 cases, cubital vein group, n = 50) were used respectively. The operating time of AVS, the success rate of AVS on both sides of the two groups were compared, and the exposure time of X-ray film and the amount of contrast agent were compared between the two groups. And adrenal venous hematoma, Results there was no significant difference in AVS exposure time and contrast medium dosage between the two groups (P = 0.05). The success rate of bilateral AVS and the right side AVS in the elbow vein group were not significantly different. The power was significantly higher than that in femoral vein group (P = 0.05). There was no significant difference in the success rate of left AVS between the two groups (P 0.05). One patient in the elbow vein group had a right adrenal hematoma. There was no operative complication in the femoral vein group, and there was no significant difference in the incidence of complications between the two groups (P 0.05). Conclusion AVS via the cubital vein is safe and feasible, and the success rate of AVS on the right side is significantly higher than that through the femoral vein. More suitable for beginners, can be used as an alternative to the femoral vein pathway.
【作者单位】：上海市高血压研究所上海交通大学医学院附属瑞金医院高血压科;新疆医科大学附属中医医院;
【基金】：上海市卫生和计划生育委员会重点项目资助(201440023)
【分类号】：R586.24

【参考文献】