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目的探讨经桡动脉路径行冠状动脉介入诊疗中,应用硝酸甘油、地尔硫■、硝酸甘油联合地尔硫■防治桡动脉痉孪的临床疗效。方法选取医院接受经桡动脉行冠状动脉介入治疗的冠状动脉粥样硬化性心脏病(简称冠心病)患者120例,随机分为硝酸甘油组、地尔硫■组、硝酸甘油联合地尔硫■组(联合用药组),各40例,成功置入动脉鞘管后在鞘管内分别经桡动脉注入硝酸甘油200μg,地尔硫■5 mg,硝酸甘油200μg联合地尔硫■2.5 mg。观察患者治疗前后的心率、收缩压、舒张压、桡动脉痉挛、心电改变、局部及全身症状。结果联合用药组桡动脉痉挛发生率、局部及全身症状发生率均低于硝酸甘油组和地尔硫■组,组间比较,差异均有统计学意义(P<0.05);联合用药组对心率和心电的影响低于硝酸甘油组和地尔硫■组,但3组间对收缩压、舒张压的影响比较,差异无统计学意义(P>0.05)。结论经桡动脉介入治疗冠心病时,局部联合应用硝酸甘油和地尔硫■可更有效地防治桡动脉痉挛,且对心率、收缩压、舒张压、心电无明显影响,并发症少,患者耐受性好,且较单一应用硝酸甘油或地尔硫■有明显的优越性,值得临床推广。
Objective To investigate the clinical effect of transradial approach to the treatment of radial artery spasm in the diagnosis and treatment of coronary artery disease by using nitroglycerin, diltiazem, nitroglycerin combined with diltiazem. Methods A total of 120 patients with coronary atherosclerotic heart disease (referred to as coronary heart disease) receiving percutaneous transluminal coronary intervention in our hospital were randomly divided into nitroglycerin group, diltiazem group, nitroglycerin combined with diltiazem Group (combination group), 40 cases in each group. After successful insertion of arterial sheath, 200 μg of nitroglycerin, 5 mg of diltiazem, 200 μg of nitroglycerin and diltiazem 2.5 mg were injected via radial artery respectively in the sheath. Heart rate, systolic blood pressure, diastolic blood pressure, radial artery spasm, ECG changes, local and systemic symptoms were observed before and after treatment. Results The incidence of radial artery spasm, local and systemic symptoms in combination group were significantly lower than those in nitroglycerin group and diltiazem group (P <0.05), and the combination group had significant difference in heart rate And ECG were lower than those of nitroglycerin group and diltiazem group. However, there was no significant difference in systolic blood pressure and diastolic blood pressure between the three groups (P> 0.05). Conclusions Transradial interventional treatment of coronary heart disease, local combination of nitroglycerin and diltiazem can be more effective in the prevention and treatment of radial artery spasm, and heart rate, systolic blood pressure, diastolic blood pressure, ECG no significant effect, less complications, patients Well tolerated, and more than a single application of nitroglycerin or diltiazem ■ has obvious advantages, worthy of clinical promotion.