经桡动脉主动脉弓及全脑血管造影术流程课件.ppt

单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,经桡动脉主动脉弓及全脑血管,造影术流程,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,器材准备,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,器材准备,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,辅助设备检查,术中用药准备,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,患者就位、过床,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,术者穿戴防护服,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,桡、腹股区消毒、铺巾,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,术中器械组装肝素盐水冲洗,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,嘱患者腿部置于合适位置,与患者沟通消除紧张情绪,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,桡动脉触诊定位、局部麻醉,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,穿刺桡动脉,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,破皮,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,置鞘、冲洗,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,有创血压监测、经静脉,或动脉鞘给药调整血压,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,组合导管、导丝导入,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,桡动脉导丝、,导管叠次通过,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,肱动脉导丝、,导管叠次通过,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,腋动脉导丝、,导管叠次通过,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,猪尾导管到位，,C,壁,角度调整选取视野,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,高压注射器接药,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,主动脉弓高压注射器造影,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,泥鳅导丝置于髂动脉水平,经泥鳅导丝交换,SIM2,导管,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,超选左侧颈总动脉、正位成像,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,机头倾斜,90,左侧颈总动脉成像,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,超选左侧锁骨下动脉,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,左侧椎动脉侧位像,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,超选右侧颈总动脉,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,右侧颈总动脉3D,造影,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,3D,后处理图像,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,超选右侧锁骨下动脉,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,右侧椎动脉侧位成像,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,导入导丝、撤除导管,桡动脉压迫止血器固定,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,拔除鞘管、旋紧止血器,手术结束,保定市脑血管病医院,介入诊疗科,Baoding Cerebral Vascular Disease Hospital,小结,血管造影术是血管介入的基础，是介入医生的基本技能。但血管造影术仍然有,3%5%,的并发症发生率，主要有穿刺点血肿、动静脉瘘、假性动脉瘤形成、血管痉挛、医源性动脉夹层形成、以及造影剂肾病等。主要由于术者对患者的适应症、禁忌症把握不严，血管,解剖变异,认识不足以及,器械掌握,不熟练所致。所以一名合格的介入医生，需要扎实的解剖与临床知识的基本功和手术经验的,积累,。,经桡动脉主动脉弓,+,全脑血管造影术是近两年来由于经验性的突破以及器材的改进得以实施的新术式，有别于常规股动脉入路具有：损伤小、出血少、路径短、并发症发生率较低、卧床时间缩短或无需卧床等优点，极大的降低了常规股动脉入路长时间制动导致的,DVT,、,PE,的发生。患者的接受度较高、在临床工作中值得推广。,