新型桡动脉止血器在临床介入中的对比研究  

The new chitosan hemostatic device in the radial artery post the intervention.

作　　者：方哲[1,2] 周玉杰[1,2] 刘宇扬[1,2] 史冬梅[1,2] 赵迎新[1,2] 李艳芳[1,2] 胡宾[1,2] 王健龙[1,2] 杨士伟[1,2] 贾得安[1,2] 王志坚[1,2] 聂斌[1,2] 葛海龙[1,2] 杨清[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所心内12病房,北京100029

出　　处：《心肺血管病杂志》2013年第2期165-168,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:对比分析新型壳聚糖止血敷料止血装置在桡动脉介入术后的临床应用。方法:2011年2月至2012年6月,在安贞医院心内科12病房经桡动脉行介入治疗1 206例患者(其中经排除标准及经股动脉途径共计132例,反关脉3例)共计1 071例患者入选。常规应用6F动脉鞘管,当需要一些特殊介入技术时(如:左主干病变、双支架术或旋磨术)更换为7F动脉鞘。将入选患者随机分为两组:普通桡动脉止血板组(OD)535例和壳聚糖止血敷料组(CD)536例。观察术后即刻及出院时桡动脉主、次临床观察指标。结果:两组入选患者基线特征显示:在年龄、性别、吸烟、血糖、血脂、高血压及体质量指数等差异无统计学意义(P>0.05)。在使用7F鞘管,以及术后使用GPIIb/IIIa受体拮抗剂等方面,壳聚糖止血敷料压迫组高于传统止血板组(P<0.05)。在满意度方面,壳聚糖止血敷料压迫止血组明显高于前者。两组通过研究对于术后内膜影响差异无统计学意义(P>0.05)。主要临床观察指标方面:出血、血肿、假性动脉瘤、前臂疼痛或不适、桡动脉内膜损伤及桡动脉闭塞等逐层进行分析,两组未见显著差别,但总血管并发症方面,壳聚糖止血敷料组明显低于止血板组。结论:对于介入术中使用7F鞘管,术后应用大量抗凝的患者,在减少总血管并发症方面以及患者满意度等方面,壳聚糖止血敷料压迫组具有很大优势。Objective：Our study was to evaluate the new chitosan hemostatic device in the radial artery post the intervention.Methods： From February 2011 to June 2012 in anzhen hospital 12 ward,a total of 1 071 patients undergoing transradial catheterization were conducted.6F and 7F sheaths were used,and the arterial sheaths were removed immediately after procedures.The patients were randomly divided into two groups,ordinary radial hemostatic device（OD） 535 cases and chitosan hemostatic device（CD） 536 cases.to observe the primary end point and second end points.Results： two groups baseline characteristics showed： in the age,sex,smoking,blood sugar,blood fat,high blood pressure,body mass index,etc had no significant differences.In patients compliance and satisfaction,chitosan hemostatic device was obviously higher.Although in the primary end point： hematoma,pain or discomfort,forearm radial artery intimal injury,did not differ between the two groups,but the total vascular complications,chitosan hemostatic device group was significantly lower than the hemostatic plate group（P0.05）,especially compare Corgared with the use of 7F sheath,and postoperative use GPIIb/IIIb receptor antagonist inhibitovs etc.Conclusion： chitosan has a strong positive charge,but erythrocytes and platelets are negatively charged.During these agents,may result in a shorter time to hemostasis and reduce the complications,inhibitovs however,it needs to be evaluated by larger number of patients.

关 键 词：桡动脉 止血装置 冠状动脉疾病 

分 类 号：R54[医药卫生—心血管疾病]