动脉支架术后穿刺处压迫方法比较

Comparison of the compression methods at puncture site after stenting

目的观察动脉支架术后立即拔鞘与延迟拔鞘、动脉压迫止血器与盐袋压迫方法之间及不同动脉鞘尺寸间在穿刺处并发症发生率方面的差异。方法选择2007年1月～2013年4月在重庆医科大学附属第一医院神经内科A区进行颅外脑动脉或。肾动脉支架植入术的患者125例，根据穿刺处压迫方法分为3组：A组（66例）为术后3h拔动脉鞘，盐袋压迫；B组（46例）为术后立即拔动脉鞘，动脉压迫止血器压迫；C组（13例）为术后3h拔动脉鞘，动脉压迫止血器压迫。每组又根据使用的动脉鞘尺寸分为6F、7F及8F亚组。记录穿刺处压迫期间并发症情况。结果支架术后穿刺处并发症只有皮下瘀血及硬结发生，主要是皮下瘀血，少数为硬结：三组总并发症发生率比较，差异无统计学意义（X^2=1．282，P〉0．05）。三组不同动脉鞘尺寸间穿刺处并发症发生率差异无统计学意义（P〉0．05）。结论动脉支架术后立即拔鞘与延迟拔鞘、动脉压迫止血器与盐袋压迫、不同动脉鞘尺寸间在穿刺处并发症发生率方面无差异，值得在临床推广应用。

Objective To observe the incidence of complications at the puncture site between immediate and delayed sheath pull, between artery compressor and salt bag methods, and among different arterial sheath sizes after artery stenting. Methods According to compression method of puncture site, 125 patients in Department of Neurology Ward A in the First Affiliated Hospital of Chongqing Medical University with extracranial artery or renal artery stenting from January 2007 to April 2013 were selected and divided into three groups： group A （66 cases） was pulled the arterial sheath 3 hours after the operation with salt bags compression; group B （46 patients） was pulled the arterial sheath immediately I with artery compressor; group C （13 cases） was pulled the arterial sheath 3 hours after operation with artery compressor. Each group was divided into 6F, 7F and 8F subgroups according to the size of the arterial sheath. The complications of puncture site during compression were recorded. Results The complication at puncture site after stenting were only subcutaneous bleeding and skin induration, the majority was subcutaneous bleeding and the minority was skin indura- tion. the The differences of complication incidence among the 3 groups was not statistically significant （X^2 = 1.282, P 〉 0.05）. The differences of puncture site complication incidence among the 3 groups during different sizes of arterial sheath was not statistically significant （P 〉 0.05）. Conclusion There are no differences in the incidence of complications at puncture site between different time pulling the sheath after stenting, artery compressor and salt bags and different arterial sheath sizes, it is worthy of clinical application.