血管缝合器的临床使用价值

Clinical Application of Suture-Mediated Closure Device(Perclose)

目的 :对比研究应用Perclose血管缝合器与人工压迫止血的效果 ,评价血管缝合器的疗效、安全性和临床使用价值。方法 :486例经股动脉行冠状动脉介入诊治术的患者 ,术后按是否接受血管缝合器止血分为缝合组 (n =2 2 8)和常规组 (n =2 5 8) ,比较止血时间、制动时间、血管并发症发生率。结果 :缝合组操作成功率为 97 3 4% ;缝合组较常规组止血时间、制动时间均明显缩短 [( 5 4± 2 2 )min比 ( 2 2 3±8 1)min ,P <0 0 0 1;( 5 3± 2 1)h比 ( 2 0 5± 9 6)h ,P <0 0 0 1] ;血管并发症发生率明显降低 ( 2 63 %比 6 98% ,P <0 0 5 )。结论 :冠状动脉介入诊治术后应用血管缝合器 (Perclose)止血是安全、有效的 ,能明显缩短止血时间和制动时间 ,减少血管并发症的发生 ,但费用较昂贵。

Objective: To compare the clinical outcomes of hemostasis between suture-mediated closure device (Perclose) and manual compression,and to assess the safety and efficacy of suture-mediated closure device.Methods: Four hundred and eighty-six patients received treatement for hemostasis with suture-mediated closure device(Suture groap,n =228) or by manual compression(Manual group,n =258),after angiography and angioplasty by way of femoral access. The time to achieve hemostasis,the braking time and vascular complications were compared between Suture group and Manual group.Results: In Suture group 97.34% of the operations were successful,compared with Manual group.The time to achieve hemostasis the braking time and vascular complications were significantly reduced (5.4±2.2 min vs 22.3±8.1 min,p <0.001; 5.3±2.1 h vs 20.5±9.6 h,p <0.001;2.63% vs 6.98%,p <0.05).Conclusion: Hemostasis with suture-mediated closure device (Perclose) is a safe and effective method after PCI.Hemostasis and ambulation can be achieved faster,and vascular complications reduced.But the device is rather costly.