2024 年第 3 期 第 19 卷

远端桡动脉途径和传统桡动脉途径穿刺对脑血管介入诊疗患者疼痛程度的影响比较

Comparison of the effects of distal transradial access and conventional transradial access puncture on pain degree in patients undergoing cerebrovascular intervention diagnosis and treatment

作者：温颖月1袁钟毓2孟丽1张晓萍3何晓芬1于蕾1王力锋1

英文作者：Wen Yingyue1 Yuan Zhongyu2 Meng Li1 Zhang Xiaoping3 He Xiaofen1 Yu Lei1 Wang Lifeng1

单位：1首都医科大学附属北京安贞医院脑血管病科，北京100029；2首都医科大学附属北京安贞医院心内科，北京100029；3首都医科大学附属北京安贞医院北京市心肺血管疾病研究所心血管重塑相关疾病教育部重点实验室，北京100029

英文单位：1Department of Cerebrovascular DiseaseBeijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 3the Key Laboratory of Cardiovascular Remodeling-related Diseases Ministry of Education Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：脑血管介入；穿刺途径；疼痛评估

英文关键词：Cerebrovascularintervention;Punctureapproach;Painassessment

• 摘要：

• 目的 探讨远端桡动脉途径（dTRA）和传统桡动脉途径（cTRA）穿刺对脑血管介入诊疗患者疼痛程度的影响差异。方法 选取2022年8月至2023年3月于首都医科大学附属北京安贞医院脑血管病科行脑血管介入诊疗的患者90例。根据操作方式的不同将患者分为cTRA组和dTRA组。使用数字评定量表（NRS）对患者术后的疼痛程度进行评估，比较2组危险因素、实验室检查指标、NRS评分以及穿刺并发症发生情况和围术期不良事件发生情况。结果 cTRA组57例，dTRA组33例。除饮酒比例、冠心病（冠状动脉粥样硬化性心脏病）比例、血糖水平外，2组危险因素、实验室检查指标差异均无统计学意义（均P>0.05）。2组均未出现NRS评分高于5分者，dTRA组内疼痛评分低的患者比例较高。dTRA组NRS评分低于cTRA组［0（0,0.5）分比2.0（1.0,3.0）分］，差异有统计学意义（Z=6.300，P<0.001）。2组穿刺点发绀发生率差异无统计学意义（P>0.05），2组围术期均无脑出血、脑梗死、心肌梗死等不良事件发生。结论 相对于cTRA穿刺而言，脑血管介入患者选择dTRA穿刺能减轻疼痛程度，且不增加并发症。

• Objective To investigate the effects of distal transradial access(dTRA) and conventional transradial access(cTRA) on pain degree in patients undergoing cerebrovascular intervention diagnosis and treatment. Methods Totally 90 patients who underwent cerebrovascular intervention diagnosis and treatment at Department of Cerebrovascular Disease, Beijing Anzhen Hospital, Capital Medical University from August 2022 to March 2023 were selected. They were divided into cTRA group and dTRA group according to the different operating methods. The postoperative pain level of the patient was evaluated using the Digital Rating Scale(NRS), and risk factors, laboratory examination indicators, NRS score, as well as the incidence of puncture complications and perioperative adverse events were compared between the two groups. Results There were 57 cases in the cTRA group and 33 cases in the dTRA group. Except for the proportion of alcohol consumption, the proportion of coronary atherosclerotic heart disease, and the level of blood glucose, there were no significant differences in risk factors and laboratory test indicators between the two groups(all P>0.05). There were no patients with NRS scores higher than 5 in both groups, and the proportion of patients with low pain scores in the dTRA group was higher. The NRS score in the dTRA group was lower than that in the cTRA group ［0（0,0.5）vs 2.0（1.0,3.0）］(Z=6.300, P<0.001). There were no statistically significant difference in the incidence of puncture points cyanosis between the two groups(P>0.05), and there were no adverse events such as cerebral hemorrhage, cerebral infarction, or myocardial infarction in both groups. Conclusion Compared with cTRA puncture, the choice of dTRA puncture in patients can reduce the degree of pain in patients with cerebrovascular intervention, and there is no increase in complications.