發(fā)布時間：2018-03-24 13:10

  本文選題：腎上腺靜脈取血　切入點：肘靜脈路徑　出處：《上海醫(yī)學(xué)》2017年04期

【摘要】：目的比較初學(xué)者采用經(jīng)肘靜脈與經(jīng)股靜脈路徑行分側(cè)腎上腺靜脈取血(AVS)的成功率及其安全性。方法 2014年8月—2015年11月間由1名初學(xué)者對連續(xù)65例原發(fā)性醛固酮增多癥患者行AVS以明確其分型,分別采用經(jīng)傳統(tǒng)經(jīng)典的股靜脈路徑(股靜脈組,15例)和經(jīng)肘靜脈路徑(肘靜脈組,50例)。比較兩組的AVS操作時間、左右兩側(cè)AVS成功率、X線攝片曝光時間、造影劑用量,以及腎上腺靜脈血腫、外周血管穿刺相關(guān)并發(fā)癥發(fā)生情況。結(jié)果兩組間AVS操作時間、X線攝片曝光時間和造影劑用量的差異均無統(tǒng)計學(xué)意義(P值均0.05)。肘靜脈組的雙側(cè)AVS成功率和右側(cè)AVS成功率均顯著高于股靜脈組(P值均0.05),兩組間左側(cè)AVS成功率的差異無統(tǒng)計學(xué)意義(P0.05)。肘靜脈組有1例患者發(fā)生右側(cè)腎上腺血腫,股靜脈組無1例患者發(fā)生手術(shù)并發(fā)癥,兩組間并發(fā)癥發(fā)生率的差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論經(jīng)肘靜脈路徑行AVS安全、可行,其右側(cè)AVS成功率顯著高于經(jīng)股靜脈路徑,更適合于初學(xué)者,可作為經(jīng)股靜脈路徑的替代方法。
[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.
【作者單位】： 上海市高血壓研究所 上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院高血壓科;新疆醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院;
【基金】：上海市衛(wèi)生和計劃生育委員會重點項目資助(201440023)
【分類號】：R586.24

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