经桡动脉主动脉弓及全脑血管造影术流程PPT课件.ppt

,经桡动脉主动脉弓及全脑血管造影术流程,1,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,器材准备,2,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,器材准备,3,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,辅助设备检查,4,.,术中用药准备,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,5,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,患者就位、过床,6,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,术者穿戴防护服,7,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,8,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,桡、腹股区消毒、铺巾,9,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,术中器械组装肝素盐水冲洗,10,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,嘱患者腿部置于合适位置与患者沟通消除紧张情绪,11,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,桡动脉触诊定位、局部麻醉,12,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,穿刺桡动脉,13,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,破皮,14,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,置鞘、冲洗,15,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,有创血压监测、经静脉或动脉鞘给药调整血压,16,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,组合导管、导丝导入,17,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,桡动脉导丝、导管叠次通过,18,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,肱动脉导丝、导管叠次通过,19,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,腋动脉导丝、导管叠次通过,20,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,猪尾导管到位，C壁角度调整选取视野,21,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,高压注射器接药,22,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,主动脉弓高压注射器造影,23,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,泥鳅导丝置于髂动脉水平经泥鳅导丝交换SIM2导管,24,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,超选左侧颈总动脉、正位成像,25,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,机头倾斜90左侧颈总动脉成像,26,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,超选左侧锁骨下动脉,27,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,左侧椎动脉侧位像,28,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,超选右侧颈总动脉,29,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,右侧颈总动脉3D造影,30,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,3D后处理图像,31,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,超选右侧锁骨下动脉,32,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,右侧椎动脉侧位成像,33,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,导入导丝、撤除导管桡动脉压迫止血器固定,34,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,拔除鞘管、旋紧止血器手术结束,35,.,保定市脑血管病医院介入诊疗科BaodingCerebralVascularDiseaseHospital,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