冠状动脉介入诊疗术后两种止血方法的比较

Comparative study of two hemostasia methods after percutaneous coronary intervention

目的:比较冠状动脉诊疗术的冠状动脉介入术(PCI)及冠状动脉造影术(CAG)后,传统压迫法与采用Angioseal缝合器止血法的制动时间和并发症发生率,为术前指导和术后护理提供依据。方法:CAG及PCI患者214例按止血方法不同分为传统压迫止血组和血管缝合组,比较两组术后制动时间和并发症的发生率。结果:采用Angioseal缝合法成功率达100%,与压迫法止血比较下肢制动时间不论单纯CAG还是PCI均显著缩短(P<0.01),缝合法术后并发症的发生率如渗血、局部血肿、迟发出血(第3天以后,至1周)、心迷走反射等显著低于传统压迫止血组(P<0.01)。结论:Angioseal缝合器止血较传统压迫止血护理操作简便,安全性高,并发症少。

AIM: To compare the complications and bed rest time of Angioseal device with manual compression for closure of femoral puncture sites and provide clinic data for the per-procedure nursing in patients undergoing percutaneous procedure. METHODS: Two hundred and fourteen consecutive patients undergoing angiography (126 patients) or coronary intervention ( PCI 88 patients) were included in this study. We used the Angio-Seal device in 84 patients for closure of femoral arterial puncture sites immediately after diagnostic (n=47) or interventional (n=37) coronary procedures independent of the coagulation status. The patients in control group (n=130)were used manual compression for closure of femoral puncture sites. The related complications and bed rest time of both groups were investigated. RESULTS: The closure device was successfully deployed in 100% after percutaneous procedure. Bed rest time in Angioseal group was decreased significantly compared with the control group (P<0.01). Major bleeding complications (hemorrhage, bleeding, local haematoma and pneumogastric nerve reflex) in Angioseal group were also decreased significantly compared with the control group (P<0.01). CONCLUSION: The Angio-Seal device is a safe and effective device with a low rate of major complications and easily nursing care.