摘 要 目的：探讨175cm0.035inch J型导引钢丝（J型导丝）在主动脉弓严重成角畸形时经股动脉入路输送6F左Judkins导管（JL导管）头端到达主动脉根部的改良方法及其疗效。方法：43例主动脉弓严重成角畸形患者分别运用常规方法（21例）与改良方法（22例）操作J型导丝与JL导管，记录导管头端从主动脉弓到抵达主动脉根部的X线透视时间，观察每例造影中左主干夹层及造影后栓塞性并发症的发生。结果：改良方法成功率（100%）远高于常规方法（42.86%），差异具有显著性（P＜0.05）。改良方法成功者X线透视时间明显短于常规方法成功者，而栓塞性并发症并未增加。结论：在主动脉弓严重成角畸形患者，J型导丝经股动脉入路输送JL导管的改良方法值得在选择性冠状动脉造影检查中常规方法不易成功时应用。
关键词 175cm0.035inch J型导丝 左Judkins导管 主动脉弓严重成角畸形 股动脉入路
Abstract Obsjective：To research effect of clinical application of the modified method of 175cm 0.035inch J shape guide wire guiding the tip of left Judkins catheter to aortic root in the cases of grave angulation of aortic arch in selective coronary angiography from femoral artery approach.Methods：43 cases of grave angulation of aortic arch were allocated into the routine method group(21 cases) and the modified method group(22 cases) at random,and applied with the two methods respectively in selective coronary angiography.The time exposed to X rays and other parameters relative to embolism were observed or measured.Results：The achievement ratio of the routine method group was 42.86%,and that of the modified method group 100% with much shorter time exposed to X rays and the same risk to embolism as that of the routine method group.Conclusions：The modified method is worth applying in the cases of grave angulation of aortic arch in selective coronary angiography from femoral artery approach.
Key words 175cm 0.035inch J shape guide wire；left Judkins catheter；grave angulation of aortic arch；femoral artery approach
资料与方法
研究对象：在经股动脉途径行选择性冠状动脉造影检查时发现的主动脉弓严重成角畸形患者。（剩余2327字）