冠状动脉造影术后血管缝合器应用的临床评价

A CLINICAL EVALUATION OF VESSEL SUTURING APPARATUS AFTER CORONARY ARTERIOGRAPHY

目的探讨冠状动脉造影术(CAG)后病人股动脉穿刺部位应用血管缝合器止血的安全性和有效性。方法对576例经股动脉行CAG病人进行前瞻性研究,所有病人术前均接受拜阿司匹林、波立维,术后接受低分子肝素治疗;随机分为两组,缝合器组(267例)在完成CAG后立即拔除股动脉鞘管,选用血管缝合器止血,压迫组(309例)在CAG术后拔除鞘管采用压迫止血。结果除在血栓形成以及动静脉瘘或假性动脉瘤方面外,缝合器组病人的主要血管并发症低于压迫组,差异均有显著性(χ2=6.63～15.23,P<0.05);而且,缝合器组病人的止血时间及卧床时间均短于压迫组,差异亦有显著性(t′=-58.08、-56.26,P<0.05)。结论应用血管缝合器是一种迅速、有效的止血方法,能明显缩短病人止血时间和卧床时间,降低血管并发症发生率,提高病人的舒适度,值得临床上推广应用。

Objective To assess the safety and efficacy of hemostasis on puncture site of femoral artery by using vessel suturing apparatus （VSA） after coronary arteriography （CAG）. Methods A prospective study was done in 576 patients undergoing CAG. All the patients received aspirin, clopidogrel and low molecular heparin before the CAG and were divided into two groups in random. VSA group （267 cases） ： VSA was applied once the sheathing canal was removed from femoral artery; and compression group （309 cases） ： by manual compression instead of VSA. Results The main vascular complications in VSA group were fewer than compression group, except thrombogenesis and arteriovenous fistula or false aneurysm （χ^2 = 6.63-15. 23, P〈 0.05）. The duration of hemostasis and lying in bed was shorter in VSA group （t′=58.08, --56.26;P〈0.05）. Conclusion The use of VSA is a fast and effective method for hemostasis, it can shorten the time to stop bleeding and bed rest, reduce vascular complications and raise the degree of comfort of patients after CAG.