龙媛　蒋烽烽

[摘要] 目的 探討胸部CT指导冠脉造影（治疗）术导管选择的价值。 方法 选择2018年1月～2019年1月我院收治的300例行冠状动脉造影（治疗）术的患者作为研究对象，采用单双号法分组，单号为对照组，双号为研究组，每组各150例，对照组采用超声指导造影导管选择，研究组采用胸部CT指导造影导管选择，对比两组患者导管选型、大小合适率、导管选择花费时间、手术总耗时、治疗总有效率及手术过程中动脉管壁损伤发生率。 结果 研究组患者导管选型合适率（98.00%）、大小合适率（98.67%）均显著高于对照组（85.33%、86.67%），研究组患者导管选择花费时间为（13.76±1.73）min、手术总耗时为（37.18±2.72）min均显著短于对照组的（21.23±2.15）min、（58.96±3.44）min，研究组患者治疗总有效率（96.67%）显著高于对照组（77.33%），研究组患者手术过程中动脉管壁损伤发生率（0.67%）显著低于对照组（15.33%），差异均有统计学意义（P<0.05）。 结论 在冠状动脉造影术中采用胸部CT指导临床患者选择造影导管，不仅能有效提高患者导管选型、大小合适率、缩短导管选择花费时间和降低其脉管壁损伤发生率，还能有效提高手术整体治疗效果，提高患者预后质量。

[关键词] 胸部CT;冠脉造影;导管选择;主动脉;冠状动脉

[中图分类号] R814.43          [文献标识码] B          [文章编号] 1673-9701（2020）30-0122-05

Value of chest CT in guiding catheter selection of coronary angiography （treatment）

LONG Yuan   JIANG Fengfeng

Department of Medical Imaging， Jinhua Central Hospital in Zhejiang Province， Jinhua   321000， China

[Abstract] Objective To explore the value of chest CT in guiding coronary angiography（treatment） catheter selection. Methods A total of 300 patients undergoing coronary angiography（treatment） admitted to our hospital from January 2018 to January 2019 were enrolled in the study. The patients were grouped according to single and double numbers. The patients with single number were enrolled as the control group. The patients with double number were enrolled as the study group. There were 150 patients in each group. The control group used ultrasound guidance to select the contrast catheter. The study group used chest CT guidance to select the contrast catheter. The catheter selection， size suitability， catheter selection time， the total time spent on surgery， the total effective rate of treatment， and the incidence of arterial wall injury during surgery and time were compared between the two groups. Results The appropriate rate of catheter selection（98.00%） and size suitability rate（98.67%） were significantly higher in the study group than those in the control group（85.33% and 86.67%）. The catheter selection time in the study group（[13.76±1.73] min）， the total time of surgery（[37.18±2.72] min） was significantly shorter than that of the control group（[21.23±2.15] min and [58.96±3.44] min）. The total effective rate of treatment in the study group（96.67%） was significantly higher than that of the control group（77.33%）. The incidence of arterial wall injury during the operation of the study group（0.67%） was significantly lower than that of the control group（15.33%）， and the differences between two groups were statistically significant（P<0.05）. Conclusion The use of chest CT in coronary angiography to guide clinical selection of contrast catheters not only can effectively improve the patient's catheter selection and size appropriate rate， shorten the catheter selection time and reduce the incidence of vascular wall injury， but also can effectively improve the overall therapeutic effect of the operation， improving the quality of the patient's prognosis.

[Key words] Chest CT; Coronary angiography; Catheter selection; Aorta; Coronary

冠状动脉造影（Coronary angiogram，CAG）是目前诊断冠心病的金标准，其是一种微创检查技术，它将特殊的导管经上肢桡动脉或大腿股动脉处（视血管条件而定）穿刺后送至冠状动脉开口，选择性地将造影剂注入冠状动脉，记录显影过程[1]。CAG可以明确冠状动脉有无狭窄、狭窄的部位、程度、范围等，并可据此指导进一步介入治疗，这种兼具诊断和治疗功能的优势，使得经皮冠状动脉造影介入术已成为临床治疗冠心病的重要手段[2]。而实施冠脉造影（治疗）术时，首先要将导管输送到冠脉开口位置，因此，正确选择合适的造影导管和引导导管是手术顺利进行的关键。……