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Heart:经左桡动脉入路可降低操作者吸入辐射剂量

2013-02-05 Heart CMT 高晓方 编译

经左桡动脉入路LRA冠脉血管造影辐射
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　　意大利学者的一项研究表明，经左桡动脉入路（LRA）与冠脉血管造影期间操作者吸收辐射剂量降低具有相关性。论文于2013年1月23日在线发表于《心脏》（Heart）。 　　此项随机、前瞻性、单中心研究共纳入413例稳定、不稳定性心绞痛以及无症状心肌缺血患者，并对LRA和右桡动脉入路（RRA）冠脉导管介入时操作者辐射暴露进行了比较。主要转归指标为操作者吸收的辐射剂量；次要转归指标为透视时间、

　　意大利学者的一项研究表明，经左桡动脉入路（LRA）与冠脉血管造影期间操作者吸收辐射剂量降低具有相关性。论文于2013年1月23日在线发表于《心脏》（Heart）。

　　此项随机、前瞻性、单中心研究共纳入413例稳定、不稳定性心绞痛以及无症状心肌缺血患者，并对LRA和右桡动脉入路（RRA）冠脉导管介入时操作者辐射暴露进行了比较。主要转归指标为操作者吸收的辐射剂量；次要转归指标为透视时间、剂量面积乘积和造影剂应用。

　　结果显示，LRA组的操作者辐射暴露显著低于RRA组（33±37对44±32 μSv；P=0.04）。两组受试者在透视时间和剂量面积乘积无显著差异，但在LRA组中二者均呈降低趋势。两组受试者的造影剂应用未见差异。

　　网友微博评论摘取：

　　@晓东大夫：我们科造影差不多左右手各一半，做多了都差不多，习惯不同而已。二者略有区别，几点个人体会：1经左手JL更容易到位，支撑力更好；2经右手时，JR更易到位；3如需要做左侧内乳动脉造影，只能经左手；4做左手时术者在患者右侧，嘱患者将已穿刺置管好的左手放在自己腹部

　　@明亮的helen：我们这都从左桡做，特别对瘦小高龄女性有优势，因为她们右锁骨下动脉迂曲很常见，从右桡做太费劲了。

　　@北大医院刘兆平：个人体会，左桡动脉途径和股动脉途径操作时还是有不小的差异，如果左侧锁骨下动脉在主动脉弓的开口偏左偏下，则操作难度并不小


Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study

OBJECTIVE:
Left radial access (LRA) and right radial access (RRA) have been shown to be safe and effective for coronary arteries catheterisation. However, the differences between the two approaches in terms of radiation exposure are still unclear. The aim of the present investigation is to evaluate in a randomised study, the dose of radiation absorbed by operators using either LRA or RRA.
DESIGN:
Randomised, prospective, double arm, single centre study.
SETTING:
University Hospital.
PATIENTS:
Male or female subjects with stable, unstable angina and silent ischaemia.
INTERVENTIONS:
The present study is a comparison of LRA and RRA for coronary artery catheterisation in terms of operators' radiation exposure.
MAIN OUTCOME MEASURES:
The primary outcome measure was the radiation dose absorbed by operators; secondary outcome measures were fluoroscopy time, dose-area product and contrast delivered.
RESULTS:
A total of 413 patients were enrolled; 209 were randomly selected to undergo diagnostic procedures with RRA and 204 with LRA. The operator's radiation exposure was significantly lower in the left radial group (LRA 33±37 μSv vs RRA 44±32 μSv, p=0.04). No significant differences were observed in  fluoroscopy time (LRA 349±231s vs RRA 370±246 s p=0.09) and dose-area product (LRA 7011.42±3617.30 μGym(2) vs RRA 7382.38±5226.61 μGym(2), p=0.80), even though in both there was a trend towards a lower level in the LRA. No differences were observed in contrast medium delivered (LRA 89.92±32.55 ml vs RRA 88.88±35.35 ml, p=0.45).
CONCLUSIONS:
The LRA was associated in the present report with a lower radiation dose absorbed by the operator during coronary angiography.

    

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    2013-11-09 124985dbm15(暂无昵称)

    #辐射剂量#

    0

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    2013-02-07 jiyangfei

    #辐射#

    0

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    2013-02-07 zhaojie88

    #ART#

    0

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    2013-02-07 12498aa2m63(暂无昵称)

    #桡动脉#

    0

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    2013-02-07 slcumt

    #HEART#

    0