单把Proglide缝合技术用于卵圆孔封堵后股静脉穿刺点止血的安全性及有效性分析  

Analysis of safety and effectiveness of single Proglide suture technique applied for hemostasis of femoral vein puncture point after removal of patent foramen ovale closure sheaths

作　　者：姜新鹏 李晓明[3] 杨航[1] 宫一宸[1] 傅元豪[1] 张喆[1] 傅瑜[2] JIANG Xin-peng;LI Xiao-ming;YANG Hang;GONG Yi-chen;FU Yuan-hao;ZHANG Zhe;FU Yu(Department of Cardiology,Peking University Third Hospital,Beijing 100191,China;Department of Neurology,Peking University Third Hospital,Beijing 100191,China;Department of Interventional Ultrasound,Beijing anzhen hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]北京大学第三医院心脏外科,北京市100191 [2]北京大学第三医院神经科,北京市100191 [3]首都医科大学附属北京安贞医院介入超声科

出　　处：《中国心血管病研究》2023年第5期409-412,共4页Chinese Journal of Cardiovascular Research

基　　金：北京大学第三医院院临床重点项目(BYSYZD2022034)。

摘　　要：目的评估在卵圆孔封堵手术中拔除输送鞘管鞘后,应用单把ProGlide血管缝合器缝合股静脉止血的安全性和有效性。方法回顾分析2022年3月至2022年8月在北京大学第三医院完成的经皮卵圆孔封堵80例患者,根据是否使用Proglide血管缝合器分为两组,一组采用自粘性绷带加压止血(压迫止血组),一组使用Proglide血管缝合器(缝合组)。所有患者均在术后次日进行血管超声检查,术后6 h、12 h观察止血效果及住院期间静脉穿刺点的并发症发生率,并完成Kolcaba舒适量表评分、医用粘胶剂相关性皮肤损伤(medical adhesive related skin injury,MARSI)评估。结果两组患者均止血成功,缝合组未出现皮下出血及瘀斑,压迫止血组5例(12.5%)出现皮下瘀斑,差异无统计学意义(P>0.05);术后6 h缝合组Kolcaba舒适量表评分明显高于压迫止血组[(79.3±6.9)比(65.2±7.2),P<0.05],术后12 h缝合组Kolcaba舒适量表评分无明显差异[(83.4±3.4)比(81.6±5.7),P=0.074]。压迫止血组9例(22.5%)发生MARSI,缝合组未出现MARSI,差异具有统计学意义(P<0.01)。住院期间两组患者均未发生静脉穿刺相关并发症。结论在经皮介入手术中,单把ProGlide预缝合技术可实现大直径静脉鞘管拔除后穿刺点的安全和有效止血。Objective To evaluate the safety and effectiveness of hemostasis at the puncture point after extubation with a single ProGlide vascular suture device in the occlusion of patent foramen ovale.Methods Eighty patients undergoing percutaneous closure of patent foramen ovale in Peking University Third Hospital from March,2022 to August,2022 were selected and divided into two groups:one group used self-adhesive bandage for hemostasis(compression hemostasis group)and the other group used Proglide vascular suture device(suture group).All the patients underwent vascular ultrasound examination the next day after the operation.The success rate of the technique and the incidence of complications at the vein puncture point during hospitalization were observed at 6 and 12 hours after the operation,and the Kolcaba comfort scale score and medical adhesive related skin injury(MARSI)evaluation were completed.Results Hemostasis was successfully achieved in both the groups,and there was no subcutaneous hemorrhage and ecchymosis in the suture group,while subcutaneous ecchymosis occurred in 5 cases(12.5%)in the compression hemostasis group,with no statistical significance(P>0.05).The score of Kolcaba comfort scale in suture group was significantly higher than that in the compression hemostasis group at 6 hours after the operation[(79.3±6.9)vs.(65.2±7.2),P<0.05],but there was no significant difference in Kolcaba comfort scale score at 12 hours after the operation[(83.4±3.4)vs.(81.6±5.7),P=0.074].MARSI occurred in 9 cases(22.5%)in the compression hemostasis group but not in the suture group,and the difference was statistically significant(P<0.01).No complications related to vein puncture occurred in both the groups during hospitalization.Conclusion In percutaneous interventional surgery,a single ProGlide pre-suture technique can achieve safe and effective hemostasis at the puncture point after extubation with the large diameter venous sheath.

关 键 词：卵圆孔封堵 股静脉 经皮血管缝合 

分 类 号：R541.1[医药卫生—心血管疾病]