ProGlide血管缝合器在经皮穿刺静-动脉模式体外膜肺氧合血管通路中的应用  

Application of ProGlide pre-close technique in establishment of percutaneous venoarterial extracorporeal membrane oxygenation

作　　者：王博 刘丽媛 梁立雯 高好考 李成祥 郭艳杰 WANG Bo;LIU Li-yuan;LIANG Li-wen;GAO Hao-kao;LI Cheng-xiang;GUO Yan-jie(Department of Cardiology,Xijing Hospital,Air Force Medical University,Xi’an 710032,Shaanxi,China;Department of Cardiology,Xi’an International Medical Center Hospital,Xi’an 710100,Shaanxi,China)

机构地区：[1]空军军医大学西京医院心脏内科,陕西西安710032 [2]西安国际医学中心医院心脏内科,陕西西安710100

出　　处：《心脏杂志》2023年第1期62-66,共5页Chinese Heart Journal

基　　金：国家自然科学基金青年项目(81800229);西安国际医学中心医院院级重点项目(2021ZD001);陕西省重点研发计划(2022SF-317)。

摘　　要：目的 评价ProGlide血管缝合器预缝合技术(PCT)在经皮穿刺静-动脉模式体外膜肺氧合(VA-ECMO)血管通路撤机止血中应用的有效性及安全性。方法 研究为前瞻性、观察性研究,连续入选2019年3月~2020年6月期间在空军军医大学西京医院心脏内科接受经皮穿刺VA-ECMO治疗的患者。将成功撤机并利用PCT技术完成血管通路缝合的患者纳入研究,分别记录PCT技术在股动、静脉的成功率及住院期间穿刺部位相关并发症发生率。结果 研究共纳入37例接受经皮穿刺VA-ECMO治疗患者,排除5例患者(其中1例是未采用PCT技术,4例在ECMO撤机前死亡),最终纳入32例患者,结果发现PCT技术在股动脉的技术成功率为97%、股静脉成功率为100%。所有患者住院期间未发生主要血管并发症,次要血管并发症发生率为6%。结论 ProGlide预缝合技术在经皮穿刺VA-ECMO撤机时可以安全有效地实现股动、静脉的快速止血,且血管并发症发生率低。AIM To evaluate the feasibility and safety of per-close technique for achieving vascular hemostasis using the ProGlide system in patients undergoing venoarterial extracorporeal membrane oxygenation(VA-ECMO). METHODS The study subjects were 32 consecutive patients with V-A ECMO between March 2019 and June 2020, in whom pre-close technique was used to achieve hemostasis at the puncture site using a ProGlide system. Technique success rate and the incidence of vascular complications at puncture site were recorded until their discharge. RESULTS The pre-close technique was performed in 32 patients. The technique success rate in the femoral artery was 97% and in the femoral vein was 100%. One patient required the use of Angioseal device for femoral artery to achieve hemostasis after weaning from ECMO. The rate of procedure-related minor vascular complications was6%. Two patients were found with hematoma by ultrasound in the femoral artery access site. No major vascular complications occurred during the periprocedural period. CONCLUSION This study indicates that the ProGlide pre-close technique is safe and efficacious in achieving hemostasis, whether in femoral artery or in vein after weaning from VA-ECMO.

关 键 词：体外膜肺氧合 经皮穿刺技术 血管预缝合 

分 类 号：R541.4[医药卫生—心血管疾病]