心导管术拔鞘管后应用经皮血管闭合器临床观察

The Clinical observation of suture-mediated closure after cardiac catheterization procedures

目的 与人工压迫止血比较 ,观察心导管术拔鞘管后应用经皮血管闭合器 (Perclose)止血的疗效及安全性。方法 189例病人在心导管术后 ,分为人工压迫止血组(95例 ,其中单纯冠脉造影 4 6例 ,行冠脉成形术 4 9例 )和Perclose止血组 (94例 ,其中单纯冠脉造影 2 5例 ,行冠脉成形术 70例 )。观察两组止血时间 ,下床活动时间 ,血管并发症。结果 Perclose止血组与人工压迫止血组相比 ,止血时间 ,下床活动时间明显缩短。Perclose止血组未见血管并发症 ,与人工压迫止血组相比差异有显著性 (P <0 0 1)。应用Per close止血成功率为 98 9%。结论 心导管术拔鞘管后应用经皮血管闭合器 (Perclose) ,缩短了止血时间和下床活动时间 ,并可减少血管穿刺点并发症及病人不适感。

Objectives To assess the safety and efficacy of suture-mediated closure device(Perclose) in patients after cardiac catheterization procedures. Methods 189 consecutive patients who underwent catheterization procedures were divided into manual compession group(95 cases,46 cases underwent coronary angiography, 49 cases underwent coronary interventional procedures) and Perclose group(94 cases, 25 cases underwent coronary angiography, 70 cases underwent coronary interventional procedures). The data of the time to hemostsis, time to ambulation and vascular complications were compared between the two groups. Results The time to achieve hemostasis and ambulation was significantly reduced in the Perclose group. There was no vascular complications in the Perclose group. There was significant difference between two groups(P<0.01). The successful rate of Perclose procedure was 98.9%. Conclusions The Perclose device can achieve hemostsis and ambulation faster than manual compression. It has the potential to reduce the access site complications and discomfort of the patients.