血管缝合器和血管封堵器在经皮冠状动脉介入诊疗术后的临床应用  

Clinic Application of Blood Vessel Suture Instrument and Blood Vessel Closure Device in Patients Undergoing Percuteneous Coronary Intervention

作　　者：陈章强[1] 姚薏[2] 戴军[3] 洪浪[1] 

机构地区：[1]江西省人民医院心内科,江西省南昌市330006 [2]华东交通大学医院 [3]中国医学科学院阜外心血管病医院

出　　处：《中国全科医学》2015年第6期696-699,共4页Chinese General Practice

摘　　要：目的探讨经皮冠状动脉介入诊疗术后应用血管缝合器与血管封堵器对患者止血时间、制动时间及并发症发生率及舒适度的影响,评估血管缝合器及血管封堵器止血的疗效及安全性。方法选择2012年2月—2014年3月江西省人民医院经股动脉穿刺行冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）的住院冠心病患者180例,采用随机数字表将患者分成为人工压迫组（A组）60例、血管缝合器组（B组）60例、血管封堵器组（C组）60例,观察3组术后止血时间、制动时间、血管创口处理时间、住院时间、患者舒适度、并发症发生率、相关费用及随访情况。结果 B组和C组术后止血时间、制动时间、血管创口处理时间、住院时间较A组均缩短,腰背酸痛、术侧肢体疼痛、腹胀、排尿困难、烦躁发生率较A组均降低（P〈0.01）;B组与C组上述指标比较,差异无统计学意义（P〉0.05）。A组术后发生并发症23例（38.3%）,B组2例（3.3%）,C组2例（3.3%）,3组术后并发症发生率比较,差异有统计学意义（χ^2=38.43,ν=2,P〈0.001）;其中B组和C组低于A组（χ2值分别为22.28和22.28,P〈0.001）;B组与C组比较,差异无统计学意义（P=1.000）。A组费用为（62±8）元,B组为（2 930±12）元,C组为（2 888±13）元,3组费用比较,差异有统计学意义（F=4.78,P〈0.001）;B组、C组费用高于A组（P〈0.01）;B组与C组比较,差异无统计学意义（P〉0.05）。随访2-3个月,复查股动脉血管彩超,B组、C组患者未见血管闭塞或严重狭窄。结论与人工压迫止血方法相比,血管缝合器和血管封堵器用于经皮冠状动脉介入诊疗术后止血效果较好、并发症少、舒适度高,但经济费用较高。Objective To investigate the impact of blood vessel suture instrument and blood vessel closure device on hemostatic time,braking time,the incidence of complications,and comfort degree in patients undergoing percutaneous coronary intervention（ PCI）,and to assess their efficacy and safety in achieving hemostasis. Methods 180 hospitalized patients who underwent coronary angiography（ CAG） via radial artery or PCI in Jiangxi Provincial People＇ s Hospital from February 2012 to March 2014,were divided into traditional manual compression group（ group A,60 cases）, blood vessel suture instrument group（ group B, 60 cases）, and blood vessel closure device group（ group C, 60 cases） by random number table method. Hemostatic time,braking time,postoperative blood vessel wound processing time,postoperative hospital stays,comfort degree,the incidence of complications, related charges, and follow- up situation of three groups were recorded. Results Hemostatic time,braking time,postoperative blood vessel wound processing time and postoperative hospital stays of group B and group C were significantly shorter than those of group A,the incidences of back pain,operative limb pain,bloating,difficulty urinating and dysphoria of group B and group C were significantly lower than those of group A（ P〈 0. 01）; there was no significant difference in the above indicators between group B and group C（ P〈 0. 05）. Postoperative complications occurred in23 cases（ 38. 3%） in group A,in group B 2 cases（ 3. 3%） and in group C 2 cases（ 3. 3%）,there was significant difference in incidence of postoperative complications among three groups（ χ^2= 38. 43,ν = 2,P〈 0. 001）; the incidence of postoperative complications in group B and group C was significantly lower than that in group A, respectively（ χ^2= 22. 28 and 22. 28,respectively,P〈 0. 001）; there was no significant difference in the incidence of postoperative complications between group B and group C（ P = 1. 000）. The costs in group A was（

关 键 词：心血管造影术 血管成形术 经腔 经皮冠状动脉 血管缝合器 血管封堵器 

分 类 号：R541.4[医药卫生—心血管疾病]