动脉压迫止血器在脑血管造影术后的应用

The application of artery compression hemostatic device in cerebral angiography

目的评价动脉止血压迫器在经股动脉脑血管造影术后应用的安全性及有效性。方法将经股动脉途径行脑血管造影术的150例患者随机分为3组,A组43例术后采用天津怡美医疗器械有限公司生产的YM-GU-1229型动脉压迫止血器压迫止血;B组48例采用传统人工手法压迫止血法:C组59例先采用手法压迫20 min,再结合动脉止血压迫器压迫止血。3组术后抗凝、抗血小板、降脂等其他常规处置相同。比较3组术后止血效果、制动时间和并发症发生率。结果 3组止血方法进行比较,其中止血时间A组为(2.19±1.5)min,B组为(3.81±2.5)min,C组为(3.69±1.7)min,A组比其他两组略短,差异有统计学意义;下肢制动时间A组为(8.2±2.1)h,B组为(23.6±23)h,C组为(7.5±1.6)h,B组明显长于另两组;止血成功率3组分别为97.8%、97.9%、100%,差异无统计学意义;观察血管并发症的发生率,A组高于其他2组,C组最少。结论单纯应用压迫器止血虽卧床时间减少,但并发症发生率显著为高;手法压迫并发症少,但是卧床时间长,患者耐受程度低;手法压迫联合压迫器压迫止血的效果好,卧床时间短、并发症少,患者舒适度高,值得临床推广使用。

Objective To assess the safety and efficacy of artery compression hemostatic device used in the cerebral angiography via femoral access. Methods A total of 150 patients who were planed to receive cerebral angiography via femoral access were randomly divided into three groups. YM-GU-1229 type of artery compression hemostatic device （Tianjin Yimei Medical Equipment Co., Ltd.） was used in patients of group A （rt= 43） to stop the bleeding when the angiographic procedure was finished. Traditional compression hemostasis by hand was adopted in patients of group B （n = 48）. Manual compression for 20 minutes with subsequent use of artery compression hemostatic device was employed in patients of group C （n = 59）. Similar postoperative anticoagulation, antiplatelet, lipid-lowering medications and other conventional managements were carried out in all patients of three groups. After the treatment, the hemostatic effect, the immobilization time of the lower extremities and the occurrence of complications were documented, and the results were compared among the three groups. Results The time needed to stop bleeding in group A, group B and group C was （2.19 ± 1.5） minutes, （3.81± 2.5） minutes and （3.69± 1.7） minutes, respectively. The time needed to stop bleeding in group A was shorter than that in both group B and group C, and the difference was statistically significant. The immobilization time of the lower extremities in group A, group B and group C was （8.2 ± 2.1） hours, （23.6 ± 2.3） hours and （7.5 ± 1.6） hours, respectively. The immobilization time of the lower extremities in group B was markedly longer than that in both group A and group C. The success rate of hemostasis in group A, group B and group C was 97.8%, 97.9% and 100%, respectively, and no significant difference existed among three groups. The incidence of vascular complications in group A was higher than that in group B and group C. Conclusion The incidence ofvascular complications is markedly increased when only artery compression hemostatic device is used, although the immobilization time of the lower extremitiesis shortened. Manual compression to stop bleeding carries fewer complications, but the patient requires rest in bed for more hours. Manual compression combined with the use of artery compression hemostatic device has excellent hemostatic effect, the bed rest time can be shortened and the complications are fewer. As the patients experience not too much physical pain during the procedure, this technique is easily accepted by the patients, therefore it is worthy to use this method in clinical practice.