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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To investigate the clinical application and value of retrograde catheterization via superficial femoral artery for the treatment of limb chronic total occlusive disease (CTO). Methods Fifty-nine patients with proximal and middle occlusive lesions of superficial femoral artery from Jan. 2013 to Jan. 2015 in department of emergency surgery were retrospectively analyzed. Percutaneous transluminal angioplasty (PTA) together with stent implantation was performed to reopen the all narrowed or obstructed superficial femoral artery.Seventeen patients received ipsilateral retrograde catheterization via superficial femoral artery together. The length of the diseased artery ranged from 6.5 to 13.4 cm, with a mean of (8.3 ± 2.9) cm, including right (11 cases)and left (8 cases) femoral arteries. After the interventional therapy patients were followed up for 1- 24 months. Results All patients were treated successfully. The proximal and middle occlusive lesions of superficial femoral artery were reopened.No serious complications were found including nerve and vessel damage+After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 14/19 of patients the superficial femoral arteries remained patent during the follow-up period. The ankle preoperative brachial index (ABI) was 0.20 to 0.51 (0.39 ± 0.06), while the postoperative ABI was 0.65 to 1.15 (0.74 ± 0.13). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusions Retrograde catheterization via superficial femoral artery is an effective alternative to treat proximal and middle occlusion of ipsilateral superficial femoral artery. It has high successful rate and safety.
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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To observe the clinical effects and complications of coronary intervention through radial artery and femoral artery.Methods A hundred and sixty patients received coronary intervention treatment or coronary angiogram in the Second Affiliated Hospital of Bengbu Medical College from March 2010 to March 2015 were enrolled in this study.The patients were divided into radial artery puncture group (n =80),who received radial artery puncture and femoral artery puncture group (n =80) who received femoral artery puncture.The general date such as puncture time,intervention success rate,time in bed,postpuncture compression time and complications such as postoperative bleeding,arterial occlusion and postoperative untoward reactions were recorded and compared.Results The intervention success rate of radial artery puncture group was 90.0％ lower than that of femoral artery puncture group (97.5％),with statistically significant differences (P＜0.05).The puncture time,postpuncture compression time,time in bed and hospital stays of radial artery puncture group were significantly shorter than those of femoral artery puncture group (P ＜0.01).As for complications,the incidences of postpuncture bleeding and vagus nerve reflex in radial artery puncture group were significantly lower than that in femoral artery puncture group (P＜0.05).As for postoperative untoward reactions,the incidences of irritable and insomnia,uroschesis,pain caused by puncture,local skin injure,back pain in radial artery puncture group were significantly lower than those in femoral artery puncture group (P＜0.01).Conclusion With the advantages of mini-invasion,such as shorter time in bed and hospital stays,lower complications and untoward reactions rates,coronary intervention through radial artery is worth of clinical application.
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Objective To study the influence of the early ambulation on postoperative patients' comfort and complications with the femoral artery puncture interventional therapy.Methods After searching for related literatures with computer,we evaluated the quality of the literatures and screened them.12 random controlled trials met the inclusion criterion.Using RevMan 5.1.2 software,we respectively made Meta analysis for patients with sense of comfort and complications after operations.Results Compared with the control groups,the experimental groups were better in back pain,abdominal pain,limb numbness and acid bilges,sleep disorder,dysuria and urinary retention than those of the control groups.And the difference in the site of puncture bleeding and hematoma had no statistical significance between the two groups.Conclusions It can improve comfort for patients without increasing incidence rate of complications by lying in bed and rest for 12 hours after interventional therapy.It reflects the patient-centered nurs-ing service concept and can improve the patients' quality of life.
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Objective To explore the effect of 3M Tegaderm transparent film on prevention of puncture complications in patients underwent aortocranial angiography via the femoral artery.Methods A retrospective analysis was carried out on 200 patients underwent aortocranial angiography via the femoral artery from February 2012 to February 2014.Eighty patients without using the transparent dressing paste were as the control group,and other 120 patients using 3M Tegaderm transparent film for fixation of arterial sheath were as the observation group.The occurrences of complications,such as arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were analyzed,and the feasibility and effectiveness of 3M Tegaderm transparent film for fixation of arterial sheath were assessed.Results The incidence rate of arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were significantly reduced in observation group compared with those in control group [5.8％ (7/120) vs.26.2％ (21/80)] (P ＜ 0.05).Conclusion Application of 3M Tegaderm transparent film with a low price and good security for fixation of femoral artery sheath can effectively reduce the occurrence of complications related to femoral artery puncture,which is worthy of wide spreading.
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Objective To discuss the application of prospective risk nursing measures in reducing the occurrence of postoperative local hematoma at femoral artery puncture site. Methods A total of 605 patients receiving femoral artery puncture for interventional management were collected as the control group , and 322 patients were used as the intervention group. The risk factors causing postoperative local hematoma at femoral artery puncture site in the control group were recorded, and based on which risk estimation survey table was designed. According to risk estimation survey, the prospective intervention measures, including risk assessment, standardization of professional training, individual health education, the improvement of care appliance, etc. were carried out for the patients of the intervention group. The occurrences of postoperative local hematoma at femoral artery puncture site were recorded and the results were compared between the two groups. Results No statistically significant differences in demographic and clinical data existed between the two groups. However, the incidence of hematoma in the intervention group was significantly lower than that in the control group (χ2 = 4.652, P < 0.05), although the difference in the severity of hematoma was not significant between the two groups. Conclusion The use of prospective risk nursing measures can effectively reduce the incidence of postoperative hematoma at femoral artery puncture site.
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Objective To study the hemostnsis effects of compression cords oppressing after femoral artery puncture and encheiresis. Methods Self-made compression cords were used to stop bleeding of femoral artery puncture sites in 2164 patients underwent 3046 cases of arteriopuncture encheiresis. The total eases were divided into group A (1482 eases) and group B (1564 cases) according to different treatment of oppression and breaking duration which were 8-10 hours for group A and 5-6 hours for group B, the hemostasis effects, discomfortableness and related complications within two groups were evaluated. Results The proportion of patients who got good hemostasis effects were 99.2% in group A, 99.0% in group B. There was no difference in hemostasis effects between two groups (P> 0.05). While the rate of discomfortableness in group A (63.8%) was higher than that in group B(42.9%) (P<0.05). The related serious complications were 2 patients in group A, but no occurred in group B. Conclusion Self-made compression cords op- pressing and 5-6 hours breaking time course can achieve both finer hemostasis effect and lower frequency of complications after femoral artery puncture and encheiresis.
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Objective To study the proper method of hamotasis by compression after femoral artery puncture for hemodialysis patients, and then decline the incidence rate of complication. Methods There were 107 hemodialysis patients in the observation group and 106 patients were in the control group. The method of using hard board paper press the point of puncture was adopted in the observation group, the traditional method was used in the control group. Compare the incidence rate of complication and the braking time after the puncture in the two groups. Results The incidence rate of complication in the control group was significant higher than that of in the observation group, P
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ObjectiveTo explore whether the posture changing can ameliorate the dysuria for patients with femoral artery puncture and catheterization, and observe the influence of posture changing on blooding in the point of puncture. Methods Changing patients′ posture under the order of nurses, and then observed the amelioration condition of dysuria. Results After using intervention method, the rate of urinary stasis decreased from 31.67% to 4.17%, the rate of using urethral catheterization also decreased from 8.33% to 1.67%. Conclusion Posture changing was an effective method to ameliorate the dysuria for patients with femoral artery puncture and catheterization.