肝脏介入治疗术后不同止血方法应用效果的比较

Comparison of Effects of Different Haemostatic Techniques after Transcatheter Arterial Chemoembolization

目的探讨肝脏介入治疗术后不同止血方法的应用效果。方法选择2010年在东方肝胆外科医院住院治疗的需经股动脉行肝脏介入治疗的患者240例为研究对象,按随机数字表法将其分为观察组和对照组,每组120例。观察组患者采用股动脉压迫器压迫止血,对照组患者采用常规绷带沙袋压迫止血,比较两组患者的止血效果、局部并发症发生情况及患者的满意度。结果经股动脉途径行肝脏介入治疗后主要并发症为穿刺部位出血、血肿、皮下瘀斑、皮肤水泡及破损。两组患者在止血时间、制动时间、术后护理时间上差异有统计学意义(P<0.05);两组患者在穿刺部位出血、血肿、皮下瘀斑上差异有统计学意义(P<0.05);观察组患者的舒适度优于对照组,差异有统计学意义(P<0.05)。结论股动脉压迫器压迫止血是值得推广的方法,但要注意预防穿刺处皮肤发生水泡和破损。

Objective To investigate the effects of different methods adopted in femoral artery hemostasis after transeatheter arterial chemoembolization（TACE）. Methods A total of 240 inpatients with TACE in the hospital in 2010 were enrolled in the study. They were randomized into observational group and control group,with 120 patients in each group. Hemostasis techniques using bandages ga bags of sand and femoral arterial compressors were utilized in the patients in the observational group and the control group respec- tively. Comparisons were conducted on the hemostatie effects,local complications and patients＇ satisfaction of these two hemostasis techniques. Results The main complications of TACE were bleeding of punctu- ring site, the formation of hematoma, subcutaneous ecehymosis, blister, and damaging skins. Significant differences were observed not only on the time of hemostasis, braking time, and postoperative care time but on the bleeding of puncturing site,the formation of hematoma and subcutaneous ecehymosis（P〈0.05）. Conclusion Hemostasis with femoral arterial compressors is an effective technique to prevent skin blisters and skin damage in the puncture sites.