摘要
目的评价采用手工压迫止血、Closure Wire封堵止血和Perclose缝合止血法处理老年冠心病介入治疗患者股动脉穿刺点的优缺点。方法将连续90例以右股动脉径路完成的老年冠心病介入治疗病例随机分为手工压迫止血组(压迫组)、Closure Wire封堵止血组(封堵组)和Perclose缝合止血组(缝合组),统计分析如下指标:操作时间,卧床时间,止血费用,接受程度,操作失败率,血管迷走反射发生率,血管并发症。结果90例老年冠心病介入治疗病例中,男63,女27;平均年龄(76.1±4.8)岁(65~96岁)。比较上述三组间7项观察指标可见:(1)缝合组和封堵组的操作时间和卧床时间明显短于压迫组;(2)封堵组的操作成功率、接受程度和并发症明显优于其他两组。(3)压迫组在操作费用方面明显优于其他两组。结论在三种股动脉穿刺点止血方法中,手工压迫法经济简便,但病人卧床时间长,局部血管并发症率较高。Perclose缝合法效果迅速可靠,但操作失败率高于封堵法且价格较贵,可以选择性地用于不能耐受长时间卧床的老年介入患者。Closure Wire封堵法成功率高,能明显减轻操作者劳动强度且容易被患者接受,适合于初学者使用。
Objective To compare the efficacy of three closure methods of femoral artery access site in aged patients. Methods Consecutive 90 aged cases of coronary artery disease were randomized into hand pressure group, Closure Wire occlusion group, and Perclose suture group. Following parameters were observed and analyzed statistically: procedure time, lying on bed time, hemostasis fee, acceptability, procedure failure rate, the rate of vagal vascular reflex, vascular complication. Results Of the total cases 63 were males and 27 females with mean age of 76.1±4.8 (65~96) years. By comparing above parameters among the three groups, it was found that (1) in Perclose suture and Closure Wire groups, the procedure time and lying on bed time were shorter significantly than the third group; (2) patients in Closure Wire group had the highest procedure success, the best acceptability and the lowest vascular complications; (3) patients in hand pressure group had the lowest procedure fee among all three groups. Conclusion Hand pressure hemostasis procedure is simple and cheap, but is accompanied with high vascular complications and long lying on bed time. Although it is quick and effective, the Perclose suture has higher closure failure and lower compliance rate than Closure Wire occlusion. It is suitable to aged patients who are intolerable to long time on bed. Closure Wire occlusion can be used by beginners as a regular closure procedure because of its easy to perform, low cost and good compliance.
出处
《中华老年多器官疾病杂志》
2008年第2期121-123,127,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly