经桡动脉介入术后弹力绷带小夹板反向固定止血临床研究

Clinical study of elastic pressure bandage hemostasis plus small splint reverse fixed wrist hemostasis after transradial intervention

目的:探讨经桡动脉行冠状动脉介入治疗(TRI)术后常规弹力绷带加压止血与弹力绷带加压加小夹板反向固定止血的临床效果。方法:将拟行TRI的304例冠心病患者按单双号随机分为常规弹力绷带加压止血组(A组,148例)和弹力绷带加压加小夹板反向固定腕关节止血组(B组,156例),比较两组疗效。主要研究终点为术后桡动脉穿刺部位出血需再次处理患者的比例,次要研究终点为血管并发症。结果:A组桡动脉出血发生率显著高于B组(4.73%比1.92%),差异有统计学意义(P<0.001)。两组桡动脉闭塞发生率等其他并发症总体无显著差异(P>0.05)。结论:常规弹力绷带和弹力绷带加小夹板反向固定腕关节止血均安全有效,但后者止血效果更好。

Objective：To explore the clinical effects of conventional elastic pressure bandage hemostasis and elastic pressure bandage plus small splint reverse fixed wrist hemostasis after transradial coronary intervention （TRI）.Methods：According to odd and even numbers,a total of 304 patients with coronary heart disease who were to receive TRI were randomly divided into conventional elastic pressure bandage hemostasis group （group A,n =148） and elastic pressure bandage plus small splint reverse fixed wrist hemostasis group （group B,n =156）,the therapeutic effects of two groups were compared.Primary endpoint was rate of bleeding needed a second treatment after TRI in radial puncture site,secondary endpoint was vascular complications.Results：Compared with group B,there was significant increase in incidence rate of radial bleeding （1.92% vs.4.73%） in group A,P〈0.001.There were no significant difference in incidence rates of radial occlusion and other complications between two groups （P〉0.05）.Conclusion：Both conventional elastic bandage hemostasis and elastic pressure bandage plus small splint reverse fixed wrist hemostasis are safe and effective,but the latter possesses better hemostasis effect.