CAJ | 학술논문

目的：探讨小剂量芬太尼联合咪唑安定预防桡动脉痉挛的效果。方法将1806例经桡动脉行冠状动脉介入手术患者随机分为药物组及对照组。药物组常规给予静脉注射芬太尼及咪唑安定，对照组不给任何药物。记录并比较2组桡动脉痉挛发生率、血管并发症、30 d 内患者死亡率、再住院率等指标。结果药物组桡动脉痉挛发生率为2．5％，显著低于对照组的8．8％（P ＜0．001）。2组患者舒适度有显著差异（P ＜0．001）。2组患者30 d 内死亡率或再住院率无显著差异（P ＞0．05）。多因素分析结果显示，影响桡动脉痉挛因素主要与性别、身高、肥胖、吸烟、导管使用数量、手术方式及手术复杂程度相关。结论小剂量芬太尼联合咪唑安定能够明显降低桡动脉痉挛的发生率、血管并发症，30 d 内死亡率及再住院率并无增加。
목적：탐토소제량분태니연합미서안정예방뇨동맥경련적효과。방법장1806례경뇨동맥행관상동맥개입수술환자수궤분위약물조급대조조。약물조상규급여정맥주사분태니급미서안정，대조조불급임하약물。기록병비교2조뇨동맥경련발생솔、혈관병발증、30 d 내환자사망솔、재주원솔등지표。결과약물조뇨동맥경련발생솔위2．5％，현저저우대조조적8．8％（P ＜0．001）。2조환자서괄도유현저차이（P ＜0．001）。2조환자30 d 내사망솔혹재주원솔무현저차이（P ＞0．05）。다인소분석결과현시，영향뇨동맥경련인소주요여성별、신고、비반、흡연、도관사용수량、수술방식급수술복잡정도상관。결론소제량분태니연합미서안정능구명현강저뇨동맥경련적발생솔、혈관병발증，30 d 내사망솔급재주원솔병무증가。
Objective To explore the effect of small dose of fentanyl combined with midazo-lam on prevention of radial artery spasm.Methods 1086 patients with elective transradial percuta-neous coronary intervention were randomly divided into medicine group and control group.The medicine group was treated with conventional intravenous injection of fentanyl and midazolam.Inci-dence rate of radial spasm,vascular complications and mortality rate or re-hospitalization rate with-in 30 days were recorded and compared between two groups.Results Incidence rate of radial spasm in medicine group was 2.5%,which was significantly lower than 8.8% in the control group (P <0.001).There were no significant differences in aspects of VAS score,mortality rate and re-hos-pitalization rate between two groups.Multivariate analysis showed that there were obvious correla-tion between incidence of radial spasm and gender,height,obesity,smoking,numbers of tubes, surgical way and difficulty of operation.Conclusion Small dose of fentanyl combined with midazo-lam during transradial interventional procedures can significantly reduce the incidence of radial spasm and vascular complications,and it won’t cause increasing of mortality rate and re-hospitalization rate.