局部使用凝血酶对降低介入诊疗后外周血管并发症的作用

Effect of local application of thrombin in decreasing peripheral vascular complications after CAG or PCI

目的:观察局部使用凝血酶对介入诊疗后外周血管并发症的影响。方法:我院2009年行冠脉造影或冠脉介入治疗患者150例,随机分为实验组和对照组各75例,对照组在造影或介入治疗结束后即刻拔鞘,徒手压迫止血后加压包扎24小时;试验组仍采用徒手压迫的方式,在压迫的同时将凝血酶浸润的纱布块加压放置于穿刺点部,压迫相同的时间后以同样的方法连同凝血酶纱布块加压包扎24小时。结果:对照组发生局部血肿8例,假性动脉瘤2例;试验组发生局部血肿2例,无假性动脉瘤。两组都没有动静脉瘘、动脉或静脉栓塞发生。总的外周血管并发症发生率对照组为13.3%,试验组为2.7%,两组间差异有统计学意义(P<0.05)。结论:介入诊疗后穿刺局部使用凝血酶能显著降低外周血管并发症的发生。

Objective：To investigate the effect of local application of thrombin in decreasing the peripheral vascular complications after coronarography（CAG） or percutaneous coronary intervention（PCI）.Methods：150 patients with CAG or PCI in our hospital in 2009 were randomly divided into two groups,75 cases in each group.The control group was performed compressing hemostasis with hand and the compression bandaging for 24 h after CAG or PCI.The experimental group still adopted the hand compression,the gauze piece with infiltrating by thrombin was simultaneously placed in the puncture site for compressing and then performed the same compression bandaging for 24 h.Results：10 cases（13.3%） in the control group had peripheral vascular complications,including local hematoma in 8 cases（10.7%）,pseudoaneurysm in 2 cases（2.7%）.But only 2 cases（2.7%） in the experimental group had local hematoma,no pseudoaneurysma occurred.The occurrence rate of peripheral vascular complications was significantly lower in the treatment group than in the control group with significant difference（P0.05）.Conclusion：The local application of thrombin can significantly decrease the rate of peripheral vascular complications after CAG or PCI.