经桡动脉径路行冠状动脉介入术后不同方法压迫止血的安全性

Comparison on safety of different hemostasis by compression after coronary intervention through transradial pathway

目的:探讨经桡动脉径路行冠状动脉介入术后不同方法压迫止血的安全性。方法:300例经桡动脉行冠状动脉造影患者术后随机分为3组,分别使用气囊压迫器、螺旋压迫器、绷带包扎进行桡动脉压迫止血,每组各100例。比较3组术后穿刺血管并发症发生率及舒适度。结果:所有患者顺利完成冠状动脉造影,3组患者穿刺部位渗血、血肿、瘀斑,皮肤水泡、破损,桡动脉狭窄或闭塞等穿刺血管并发症发生率比较,差异无统计学意义(P>0.05);但气囊压迫器组患者肢端肿胀、麻木、发绀发生率和患者舒适度评分显著优于螺旋压迫器组和绷带包扎组(P<0.01)。结论:气囊压迫器、螺旋压迫器、绷带包扎止血成功率均较高,血管穿刺并发症发生率较低,临床应用安全、有效;其中气囊压迫器的安全性明显优于螺旋压迫器和绷带包扎。

Objective： To investigate the safety of different hemostasis by compression after transradial coronary intervention. Methods： Three hundred patients,who underwent transradial coronary arteriography,were randomly divided into three groups after the operation,using radial artery balloon compressor,radial artery screw compressor and bandaging,respectively（ n = 100 each）. The incidence of vascular puncture complications and degree of patient comfort after the operation were compared among the three groups. Results： All patients were successfully completed the coronary angiography. There were no statistically significant differences in the incidence of vascular puncture complications,such as bleeding,hematoma and ecchymosis at the puncture sites,skin blister,radial artery stenosis or occlusion among the three groups（ P 〉0. 05）. However,the incidence of limbs swelling,numbness and cyanosis,and the degree of patient comfort were significantly superior in the balloon compressor group than those in the screw compressor group and bandaging group（ P〈 0. 01）.Conclusion： Radial artery balloon compressor,radial artery screw compressor and bandaging have high success rate,low incidence of vascular puncture complications,and safe and effective clinical application. And the safety of radial artery balloon compressor is significantly superior to the radial artery screw compressor and bandaging.