桡动脉止血器在经肱动脉冠状动脉介入术中的应用  

Radial artery hemostatic device applied in trans-brachial coronary intervention

作　　者：王宁[1] 程冠良 王亮[1] 杨泉[1] 张文超 WANG Ning;CHENG Guan-liang;WANG Liang;YANG Quan;ZHANG Wen-chao(Department of Cardiology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院心血管内科,北京102206

出　　处：《中国介入心脏病学杂志》2025年第4期195-200,共6页Chinese Journal of Interventional Cardiology

基　　金：国家自然科学基金项目(81970275)。

摘　　要：目的分析桡动脉止血器在经肱动脉冠状动脉介入术中应用的安全性和有效性。方法回顾性分析2018年1月1日至2023年12月31日在北京大学国际医院接受经肱动脉入路冠状动脉介入诊疗的患者。根据术后止血方式将其分为桡动脉止血器组(170例)和常规压迫组(100例),比较两组间穿刺点周围出血并发症发生率及临床特征。结果经肱动脉入路冠状动脉介入治疗患者共270例,共出现18例并发症,其中穿刺点周围出血17例(16例为轻微出血,1例为严重出血),一过性正中神经损伤1例,整体并发症发生率为6.7%,穿刺点周围出血发生率为6.3%。桡动脉止血器组出血发生率为5.9%,常规压迫组为7.0%,两组差异无统计学意义(P=0.715)。多因素回归分析提示女性为穿刺点周围出血的独立危险因素(OR 4.57,95%CI 1.40~14.96,P=0.012)。随着技术积累,经肱动脉入路及桡动脉止血器的应用逐年增加(均P<0.010)。结论桡动脉止血器在经肱动脉冠状动脉介入中可有效止血,具备较好安全性,其简便性和有效性为经肱动脉入路止血提供了新的处理策略。Objective To investigate the safety and efficacy of the radial artery hemostatic device in trans-brachial coronary intervention,and assess its effectiveness.Methods A retrospective analysis was conducted on patients who underwent trans-brachial coronary intervention at Peking University International Hospital from January 1,2018 to December 31,2023.The patients were divided into the radial artery hemostatic device group(170 cases)and the conventional compression group(100 cases)based on the postoperative hemostasis method,and the incidence of complications and clinical characteristics were compared between the two groups.Results A total of 270 patients underwent trans-brachial coronary intervention,with 18 complications occurring.Among them,17 cases were hemorrhage around the puncture site(16 cases were mild and 1 case was severe)and 1 was transient median nerve injury.The overall complication rate was 6.7%,and the incidence of hemorrhage around the puncture site was 6.3%.The hemorrhage rate in the radial artery hemostatic device group was 5.9%,while that in the conventional compression group was 7.0%,with no statistically significant difference between the two groups(P=0.715).Multivariate regression analysis indicated that female was an independent 4risk factor for hemorrhage around the puncture site(OR 4.57,95%CI 1.40–14.96,P=0.012).With the accumulation of technology,the application of trans-brachial access and radial artery hemostatic devices increased year by year(both P<0.010).Conclusions The radial artery hemostatic device effectively controls bleeding in trans-brachial coronary interventions and demonstrates satisfactory safety.Its simplicity and efficacy provide a new strategy for hemostatic management in percutaneous trans-brachial access,which may gradually become the new standard in the future.

关 键 词：肱动脉 经皮冠状动脉介入治疗 桡动脉止血器 

分 类 号：R541[医药卫生—心血管疾病]