“米”字包扎在冠状动脉介入治疗术后止血中的应用  

Application of "Mi"-bandage in postoperative hemostasis of percutaneous coronary intervention therapy

作　　者：唐萍[1] 任洪艳[1] 罗素新[1] 

机构地区：[1]重庆医科大学附属第一医院心内科,重庆400016

出　　处：《现代医药卫生》2015年第15期2262-2264,共3页Journal of Modern Medicine & Health

基　　金：国家临床重点专科建设项目经费资助(财社[2010]305号);重庆市卫生局资助项目(2010-2-052)

摘　　要：目的探讨经桡动脉行冠状动脉介入诊疗术后2种止血方法的安全性和有效性。方法选取2014年11月1-30日在该院经桡动脉行冠状动脉介入诊疗的283例患者,采用随机数字表法分为＂米＂字包扎组142例和压迫器组141例。＂米＂字包扎组患者术毕用加压胶布＂米＂字包扎法,压迫器组患者术毕用桡动脉压迫止血器止血,比较2种止血方法的安全性和有效性,并分析影响压迫器止血效果的因素。结果 ＂米＂字包扎组在止血失败率、手臂肿胀发生率、皮肤发绀发生率、脉搏血氧饱和度异常发生率方面[0.0%（0/142）、5.6%（8/142）、11.3%（16/142）、2.1%（3/142）]均优于压迫器组[17.7%（25/141）、24.8%（35/141）、69.5%（98/141）、7.1%（10/141）],差异均有统计学意义（P〈0.01或0.05）;＂米＂字包扎组轻度及以上不适发生率[23.2%（33/142）]低于压迫器组[39.0%（55/141）],差异有统计学意义（P〈0.05）。压迫器组患者在穿刺点偏离桡动脉结节、穿刺频次大于或等于3针、术中即刻出现手臂肿胀、行支架术、桡动脉痉挛、手术时间大于2 h、操作者经验缺乏方面止血失败率均高于止血成功率,差异均有统计学意义（P〈0.01或0.05）。结论 ＂米＂字包扎止血法在经桡动脉行冠状动脉介入术后止血的有效性明显优于压迫器止血法,出现穿刺位置偏离桡动脉结节、反复穿刺、术中即刻出现手臂肿胀等因素宜首选＂米＂字包扎法,因其价廉,更值得基层医院推广。Objective To compare the efficacy and safety between the two kinds of hemostasis method after percutaneous coronary intervention（PCI） by transradial artery. Methods 283 patients with PCI by transradial artery in our hospital from November 1-30,2014 were selected,among them,142 cases adopted the ＂Mi＂ bandage by pressing adhesive plaster at the end of opera-tion（ ＂mi＂ bandage group） and 141 cases used the radial compression hemostat for conducting hemostasis（compressor group）. The safety and effectiveness were compared between the two kinds of hemostasis method. The factors affecting the hemostasis effect of compressor were analyzed. Results The ＂Mi＂ bandage group was superior to the compressor group in the aspects of the hemosta-sis failure rate[0.0%（0/142） vs. 17.7%（25/141）],occurrence rate of swelling[5.6%（8/142） vs. 24.8%（35/141）],occurrence rate of skin cyanosis[11.3%（16/142） vs. 69.5%（98/141）] and abnormal rate of pulse oxygen saturation[2.1%（3/142） vs. 7.1%（10/141）],the differences were statistically significant（P〈0.01 or 0.05）. The occurrence rate of mild discomfort or more in the ＂Mi＂-bandage group was 23.2%（33/142）,which was lower than 39.1%（55/141） in the compressor group,the difference was statistically significant（P 0.05）. The hemostasis failure rate in the compressor group was higher the hemostasis success rate in the aspects of the puncture point apart from the radial arterial nodule,puncture frequency more than or equal to 3 times,immediately appearing swelling during operation,performing stenting,radial artery spasm,operative time more than 2 h and operator lacking experience,the differences were statistically significant（P〈0.01 or 0.05）. Conclusion The effectiveness of ＂Mi＂ bandage hemostasis method in postoperative hemostasis is significantly superior to the compressor hemostasis method. When appearing the factors like the puncture location deviated from the radial artery nodule,repeated puncture,arm swelling

关 键 词：止血 冠状动脉疾病 桡动脉 “米”字包扎 压迫止血 

分 类 号：R815[医药卫生—放射医学]