经桡动脉穿刺行介入性冠脉诊疗术后局部止血相关处理方法探讨

Methods of local hemostasis after the puncturing position of radial artery in coronary diagnose and treatment

目的探讨经桡动脉穿刺行介入性冠脉诊疗术后局部止血相关处理方法。方法将324例经桡动脉穿刺行冠脉诊疗术后的患者随机平均分成对照组、观察A组、观察B组各108例,对照组患者术后使用传统止血方法,观察A组患者术后采用弹力纱布止血,B组使用桡动脉止血器压迫4小时后换弹力纱布止血。观察3组患者穿刺出血、手部瘀肿及疼痛情况。选择出现手部中度瘀斑的32例病例,再次随机分为安慰组10例和实验A、B组各11例,实验A组使用硫酸镁加高糖维生素B12外敷,实验B组在A组基础上加利多卡因外敷,观察3组患者瘀肿的消失度。结果观察B组穿刺出血、手部瘀肿及疼痛改善情况均低于观察A组,且明显低于对照组,差异有统计学意义(P<0.05);实验B组手部瘀斑缓解高于A组,差异亦有统计学意义(P<0.05)。结论使用桡动脉止血器止血后换用弹力纱布继续止血效果确切。术后局部瘀斑处理时硫酸镁加高糖维生素B12联合利多卡因外敷可明显改善预后。

Objective To observe the methods of local hemostasis after the puncturing position of radial artery in coronary diagnose and treatment. Methods 324 cases of patients performed CAG or PCI by the puncturing position of ra- dial artery were equally divided into control group and observation group A and group B. Patients of control group used traditional hemostasis, patients of group A used elastic gauze and patients of group B used tourniquet of radial artery. The bleeding eeehymosis and ache were observed. The midrange eeehymosis in hand including 32 cases were randomly di- vided into comfortable group （10 cases） and experiment group one （11 cases） and experiment group two （11 cases）. The experiment group one was treated with magnesium sulfate and high glucose admixture vitamin B12. The group two was treated with admixture lidocaine. Results The bleeding, hemostasis and ache of group B were lower than that of group A. The difference was statistically significant（P〈0.05）. Experiment group two about abolition of eechymosis surpass that of Experiment group one（P〈0. 05）. Conclusion It is effective of Hemostasis treated by elastic gauze after radial ar- tery tourniquet.