血管闭合器、血管压迫器和弹力绷带加压法3种止血方式用于周围血管介入术的对照研究  

Comparative study of three hemostasis methods of hemostatic vascular closure device,vascular compression device and elastic bandage compression in peripheral vascular intervention

作　　者：单海丰 侯士阳 郭永伟 周密 康春博 Shan Haifeng;Hou Shiyang;Guo Yongwei;Zhou Mi;Kang Chunbo(Department of Vascular Intervention,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China;Department of Ultrasound,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China;Department of Vascular Surgery,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学附属北京康复医院血管介入科,北京100144 [2]首都医科大学附属北京康复医院超声科,北京100144 [3]首都医科大学宣武医院血管外科,北京100053

出　　处：《血管与腔内血管外科杂志》2022年第4期385-389,394,共6页Journal of Vascular and Endovascular Surgery

基　　金：科研人才启动基金(2019R-001)。

摘　　要：目的系统评价经股动脉穿刺后血管闭合器、血管压迫器、弹力绷带加压法3种止血方式的安全性及效果。方法选取2019年2月至2021年1月首都医科大学附属北京康复医院收治的121例行周围血管介入术的非下肢动脉病变患者,按照住院顺序号将患者分为血管闭合器组(n=42,应用血管闭合器进行股动脉穿刺部位止血)、血管压迫器组(n=40,应用股动脉电子压迫止血器进行股动脉穿刺部位止血)与弹力绷带压迫组(n=39,应用弹力绷带压迫进行股动脉穿刺部位止血)。比较3组患者术前、术后1 d及术后3个月手术穿刺部位及周围3 cm内股动脉最小内径及收缩期峰值血流速度,并观察其术后1 d轻度和严重并发症的发生情况。结果术后1 d,血管闭合器组患者的穿刺部位及周围3 cm内股动脉最小内径小于血管压迫器组和弹力绷带压迫组患者,且血管压迫器组患者的穿刺部位及周围3 cm内股动脉最小内径小于弹力绷带压迫组患者(P<0.05)。术后1 d,血管闭合器组、血管压迫器组患者穿刺处范围内最小内径处的收缩期峰值血流速度均低于弹力绷带压迫组患者(P<0.05)。术后3个月,血管闭合器组患者的穿刺部位及周围3 cm内股动脉最小内径小于弹力绷带压迫组患者;血管闭合器组患者穿刺处范围内最小内径处的收缩期峰值血流速度低于血管压迫器组、弹力绷带压迫组患者,且血管压迫器组患者穿刺处范围内最小内径处的收缩期峰值血流速度低于弹力绷带压迫组患者(P<0.05)。术后1 d,3组患者的轻度及严重并发症总发生率比较,差异均无统计学意义(P>0.05)。结论经股动脉穿刺后3种止血方式均影响穿刺部位附近的血管内径及收缩期峰值血流速度。血管闭合器对患者术后3个月预后情况的影响最大,其次是血管压迫器,弹力绷带加压法对患者术后3个月预后的影响最小。Objective To investigate the safety and clinical effect of three hemostasis methods of vascular closure device,vascular compression device and elastic bandage compression in puncture site of femoral artery.Method A total of 121 patients without lower extremity artery lesions who underwent the peripheral vascular intervention via femoral artery puncture from February 2019 to January 2021 in Beijing Rehabilitation Hospital of Capital Medical University were selected.According to the sequence number of hospitalization,the patients were divided into the vascular closure device group(n=42,received hemostatic vascular closure device),vascular compression device group(n=40,received hemostatic electrical vascular compression device of femoral artery)and elastic bandage compression group(n=39,received hemostatic elastic bandage compression).The minimum internal diameter of the femoral artery at the puncture and within surrounding 3 cm of puncture sites and the peak velocity of the systolic blood flow before operation and l day and 3 months after operation were compared among the three groups.And the incidence of mild and severe complications were observed at 1 day after operation.Result One day after operation,the minimum internal diameter of the femoral artery at the puncture and within surrounding 3 cm of puncture sites in the vascular closure device group was lower than that in the vascular compression device group and elastic bandage compression group,the vascular compression device group lower than that in elastic bandage compression group(P<0.05);the peak velocity of the systolic blood flow at the smallest inner diameter of the puncture site in vascular closure device group and vascular compression device group was lower than that in elastic bandage compression group(P<0.05).Three months after operation,the minimum internal diameter of the femoral artery at the puncture and within surrounding 3 cm of puncture sites in the vascular closure device group was lower than that in the elastic bandage compression group;the

关 键 词：周围血管介入术 血管闭合器 血管压迫器 弹力绷带 股动脉 止血 

分 类 号：R543[医药卫生—心血管疾病]