冠脉造影和介入治疗术后Angio-Seal血管闭合装置的应用  

The Use of Angio-Seal Vascular Closure Device after Coronary Angiography and Percutaneous Coronary Intervention

作　　者：张峰[1,2] 钱菊英[1,2] 葛均波[1,2] 樊冰[1,2] 王齐兵[1,2] 葛雷[1,2] 严卫[1,2] 颜彦[1,2] 

机构地区：[1]复旦大学附属中山医院心内科 [2]上海市心血管病研究所,上海200032

出　　处：《中国临床医学》2005年第3期389-391,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:Angio—Seal血管闭合装置是一种新型的止血装置。本研究旨在探讨在冠状动脉造影和介入治疗术后,使用Angio-Seal血管闭合装置对股动脉穿刺部位进行止血的有效性、安全性及并发症发生情况。方法:2003年5月-2004年2月期间,我院心内科共对129例(男性99例,女性30例,平均年龄63.2±11.5岁)行冠脉造影或介入治疗的患者使用了Angio-Seal血管闭合装置进行股动脉穿刺部位的止血,观察使用该装置所需的止血时间、患者的下肢制动时问以及止血即刻至术后7d内局部并发症的发生情况。结果:129例患者中,128例即刻止血成功,成功率为99.2%。失败的1例为胶原栓经鞘管送入后未能充分打开,撤出输送鞘管时被一并拉出。成功止血的128例患者的止血时间为0.5-3min(平均1.1±0.6min);术后下肢平均制动时间为7.1±3.4h,其中112例患者在4-6h可以下床活动,16例患者因局部渗血而延长下肢制动时间至10-24h;止血过程中和止血后无1例患者发生显著迷走反应;术后随访7d,发生皮下血肿(直径≥3cm)5例,假性动脉瘤1例,局部并发症的总发生率为4.69%,无1例需行外科血管修复术。结论:在冠状动脉造影和介入治疗术后,Angio-Seal血管闭合装置是一种安全、有效的动脉止血装置,它可以缩短止血时间和术后肢体制动时间,并有助于减少局部并发症的发生。Objective: To assess the efficiency and safety of Angio-Seal vascular closure device, for hemostasisin femoral artery puncture site after coronary angiography and percutaneous coronary intervention. Methods: From May to December 2003, A total of 129 patients (male 99, female 30) aged 63. 2±11.5 years received Angio-Seal vascular closure devices for hemostasis after coronary angiography or percutaneous coronary intervention. The time to hemostasis, the time to ambulation and the incidence of local complications were assessed. Results: Immediate hemostasis was successfully achieved in 128 patients (99. 2%). In 1 patient, device placement was abandoned due to inability of the collagen plug to properly deploy out of the sheath tip. The mean time to hemostasis was 1.1 ± 0. 6 rnin, and the patients were able to ambulate 7. 1 ± 3. 4 h after sheath removal. Among them, 16 patients could not ambulate in 6 hours after device deployment because of oozing. There were 5 cases of palpable mass and 1 case of false aneurysm at 7 days of follow-up, but no surgical repairment was required in any patient. Conclusion: After coronary angiography and percutaneous coronary intervention, the use of Angio-Seal closure devices resulted in rapid hemostasis and early ambulation with low incidence of local vascular complications.

关 键 词：血管闭合装置 止血 

分 类 号：R816.2[医药卫生—放射医学]