冠状动脉介入治疗术后Angio-Seal血管封堵器的应用研究

The Use of Angio-Seal Vascular Closure Device after Coronary Intervention

目的比较经股动脉冠脉介入术后应用Angio-Seal血管封堵器(VCD)与徒手压迫止血法(MC)的临床疗效。方法将186例患者随机分成VCD及MC两组各93例。VCD组应用Angio-seal血管封堵器,MC组采用人工徒手压迫,观察止血成功率、止血时间、肢体制动时间以及并发症。结果VCD组止血时间、加压包扎时间和肢体制动时间较MC组显著缩短,差异有统计学意义(P<0.01),3例于VCD置入后仍然有明显出血,均给予徒手加压15min左右成功止血。MC组4例也由于患者肥胖,股动脉位置较深,徒手压迫止血时间>20min,仍然有明显出血,继续压迫止血10～20min后成功止血。两组止血成功率间差异无统计学意义(P>0.05),并发症的发生率VCD组明显低于MC组,差异有统计学意义(P<0.01)。结论应用VCD安全有效的,且可以明显降低止血、制动时间和并发症发生率,尤其适用于一些穿刺处并发症高危患者或不能耐受长时间制动的患者。

Objective We compared the use of manual compression （MC） and Anglo - Seal Vascular closure devices （VCD） to achieve hemostasis following Percutaneous Coronary Intervention （PCI） in order to evaluate safety and efficacy. Methods A total of 186 patients were divided into 2 groups randomly, one group including 93 patients received manual compression, while the other group received Angio - Seal closure devices. The time to hemostasis, the time to ambulation and the incidence of local complications were assessed. Results Immediate hemostasis was successfully achieved in 90 patients （96.7%） of VCD group, but has no difference in hemostasis rate between two groups （96. 7 vs 92. 4% ）. Compared with MC, The time to hemostasis, the time to ambulation and the incidence of local complications were notably decreased [ （ 1.2 ±0. 5） vs （20.4±2.1） min, （4.2 ±0.5） vs （23.4 ±2. 1） h, （1.07 vs8.60% ）, P 〈0.05]. Conclusion After Coronary Intervention, the use of Anglo - Seal closure devices was safe and effective, which resulted in rapid hemostasis and early ambulation with low incidence of local vascular complications.