冠状动脉介入性诊疗术后血管闭合装置与人工压迫止血比较的研究  

Comparison of arterial puncture closure devices with standard manual compression after coronary angiography and percutaneous coronary intervention

作　　者：高筱红 姚远 魏广林 周书文 吴海军 张崟[2] 贺立群[2] 马长生[2] 

机构地区：[1]平谷区医院心血管科 [2]首都医科大学附属北京安贞医院

出　　处：《中国心血管病研究》2006年第10期762-764,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的比较血管闭合装置与人工压迫止血对经皮冠状动脉介入性诊疗术后外周血管并发症的影响。方法回顾分析2005年1月至2005年6月间,我院经股动脉介入性诊疗术后使用血管闭合装置与人工压迫止血后外周血管并发症的发生率。结果122例患者接受了PCI,60例患者采取人工压迫止血,术后卧床时间(12.10±0.76)h,血管穿刺部位血肿11例,动静脉漏1例,出血假性动脉瘤2例;62例患者使用血管闭合装置,术后卧床时间(6.65±2.10)h,血管穿刺部位血肿5例,无动静脉漏和出血假性动脉瘤。使用血管闭合装置组与人工压迫组相比,患者的术后卧床时间明显缩短[(6.65±2.10)h和(12.10±0.76)h,P<0.001),血肿(18.3%和8.1%,P=0.091)、动静脉漏(1.6%和0,P=0.323)、假性动脉瘤(3.3%和0,P=0.147)均有不同程度的下降,但差异无统计学意义。结论PCI后使用外周血管闭合装置可缩短患者卧床时间,提高患者舒适度,但并不能明显降低外周血管并发症的发生率。Objective To evaluate the perivascular complications of hemostasis with vascular closure devices versus manual compression in the coronary artery angiography （CAG） and peroutaneous coronary interventions （PCI）. Methods Analysing retrospectively the perivascular complications in the 122 patients treated by CAG and PCI from January 2005 to june 2005, 60 patients stanched by manual compression and 62 by vascular closure devices. Results In the manual compression group（60）, the time to ambulation （12.10±0.76）h, 11 cases with hematoma at access sites, 1 case with arteriovenous fistula, 2 cases with pseudoaneurysm. In the vascular closure devices group （62）, the time to ambulation（6.65±2.10）h,5 cases with hematoma,and no case with arteriovenous fistula or pseudoaneurysm. Comparing the two methods, vascular closure devices application does improve patient satisfaction and time to ambulation[ （6.65±2.10）h vs.（12.10±0.76）h,P〈0.001 ] ,but the vascular complications of vascular closure devices were not superior to that of with manual compression. Conclusion Vascular closure devices application does improve patient satisfaction and time to ambulation, but not accompaniment with the reduction of vascular complications rates.

关 键 词：血管形成术 经腔 经皮冠状动脉 止血 外周血管疾病/并发症 

分 类 号：R816.2[医药卫生—放射医学]