法舒地尔在经桡动脉冠状动脉介入治疗中预防桡动脉痉挛疗效分析

摘要

目的 观察法舒地尔在经桡动脉冠状动脉介入中预防桡动脉痉挛(RAS)的疗效.方法 入选300例行经桡动脉冠状动脉介入治疗的冠心病患者,随机分为法舒地尔组(n=102)、硝酸甘油+维拉帕米组(n=88)、对照组(n=110).法舒地尔组术前半小时静滴法舒地尔30mg;硝酸甘油+维拉帕米组在置入动脉鞘管后经鞘管注入硝酸甘油200μg+维拉帕米5mg;对照组无特殊处理.结果 法舒地尔组、硝酸甘油+维拉帕米组与对照组RAS发生率分别为5.88%、5.68%、15.45%;前两组无统计学差异(P＞0.05)但均低于对照组,且差异有统计学意义(P＜0.05).法舒地尔组局部症状和全身症状发生率均低于硝酸甘油+维拉帕米组及对照组,差异均有统计学意义(P＜0.05).结论 法舒地尔能减少经皮冠状动脉介入治疗中RAS的发生率,且较少发生局部及全身症状.%Objective To observe the preventive effect of fasudil on radial artery spasm ( RAS ) during transradial coronary intervention. Methods The patients (n=300 ) with coronary heart disease ( CHD ) having transradial coronary intervention were selected and randomly divided into fasudil group ( group A, n= 102) , nitroglycerin+verapamil group ( group B, fi=88 ) and control group ( group C, n=l 10 ) . Group A was given intravenous drip of fasudil ( 30 mg) 30 minutes before the operation after establishing venous channel with normal saline solution, group B was given nitroglycerin ( 200 mg ) and verapamil ( 5 mg ) through arterial sheath catheter 30 minutes before the operation after establishing venous channel and implanting arterial sheath catheter, and group C was not given special treatment besides of establishing venous channel with normal saline solution 30 minutes before the operation. The occurrence proportion of RAS and other local or general symptoms were observed in three groups. Results The incidence of RAS was, respectively, 5.88%, 5.68% and 15.45%' in three groups. The incidence of RAS had no statistical difference between group A and group B ( P>0.05 ) , and that was lower in group A and group B than that in group C (P<0.05 ) . In group A, the incidence of local symptoms was lower than that in group B and group C ( P<0.05 ) , and the incidence of general symptoms was lower than that in group B ( P<0.05 ) . Conclusion Fasudil can reduce the incidence of RAS and local or general symptoms during transradial coronary intervention.