股动脉穿刺术后改良加压包扎方法的评价

Evaluation on the improved technique of pressurized bandaging after femoral artery puncture operation

目的评价股动脉穿刺术后改良的直接包扎法的止血效果和局部血管并发症的发生率。方法将663例患者(其中普通介入亚组529例,PCI亚组134例)行股动脉穿刺术进行分别随机分为2组:改良包扎组(335例)和传统压迫组(328例),比较两组局部血管并发症的发生率。结果改良包扎组的局部血肿的发生率(3.9%)明显低于传统压迫组(12.2%,P=0.00008),但局部皮肤破损的发生率则明显高于传统压迫组(6.3%和2.4%,P=0.015),但改良包扎组的后100例改进包扎后的皮肤破损率(3.0%)与传统压迫组(2.4%)相当。3例深静脉血栓形成及两例肺动脉栓塞患者均发生在普通介入亚组。结论采用改良加压包扎术压迫股动脉穿刺点止血效果优于传统组,但局部皮损发生率高于传统组,与操作技巧有关。

Objective To evaluate the peripheral vascular complications using improved technique of pressurized bandaging after femoral artery puncture operation. Methods 663 patients including 529 patients undergoing RFCA and coronary angiography and 134 undergoing PCI were randomly divided to 2 groups： Improved bandaging group 0BG） and Con- ventional bandaging group（CBG）, and their peripheral vascular complications, including hemostasis, local skin injury effect and deep vein thrombosis, et al. Results Incidence of subcutaneous haematoma in femoral, artery cannulation position in IBG was lower than in CBG, but the rate of skin injury in IBG was higher than in CBG. The incidence of deep vein thrombosis was the same in both groups. Conclusion The improved technique of pressurized bandaging after femoral artery puncture operation is more simple, safer than conventional bandaging method, and the skill of pressurized bandaging is very important.