经肱动脉途径冠状动脉介入治疗并发症的预防及处理

目的:评价130例次经肱动脉途径冠状动脉介入治疗(PCI术)局部并发症情况.方法:连续入选2009年3月至2011年12月我院经肱动脉途径冠状动脉PCI术的病例130例次.分析经肱动脉介入治疗操作并发症情况.结果:共24例患者发生了局部并发症,并发症发生率为18.5％.其中穿刺局部发生血肿22例(16.9％),其中1例合并骨筋膜室综合征及正中神经损伤(0.8％),局部神经损伤1例(0.8％),假性动脉瘤1例(0.8％).经处理后血肿全部吸收,最后仍有1例正中神经损伤和1例假性动脉瘤未能完全康复.结论:经肱动脉途径冠状动脉PCI术并发症发生率较高,熟悉肱动脉穿刺方法、掌握标准的压迫止血包扎方案、术后肢体夹板制动、并对其并发症有足够的认识和处理对策的充分准备可以减少并发症及其不良后果的发生.

Treatment and Prevention about the Complications of Percutaneous Coronary Intervention Therapy by the Brachial Artery

Objective: To evaluate the local complications of percutaneous coronary intervention(PCI) therapy by the brachial artery.Methods: 130 cases were consecutively selected from March 2009 to December 2011 cases of brachial artery approach for PCI.The complications of brachial artery interventional treatment were analyzed.Result: A total of 24 cases of patients with local complications,the incidence rate was 18.5%.There were 22 cases of local hematoma in puncture side(16.9%),including 1 case with psteofascial compartment syndrome and median nerve injury(0.8%),1 case with partial nerve injury(0.8%) and pseudoaneurysm in 1 case(0.8%).After treatment,the hematomas were all absorbed,but a median nerve injury and pseudoaneurysm had not been completely recovered.Conclusion: The complication of PCI by the brachial artery had higher incident,and it can reduce the occurrence of complications and adverse consequences that being familiar with the brachial artery puncture method,mastering standard pressurized dressing program,limb splint after operation,having sufficient knowledge of the complications and fully prepared countermeasures.