冠状动脉介入诊疗术后 TR-Band 止血器止血策略的研究

Strategy of postoperative TR -Band tourniquet to stop bleedingin coronary interventional treatment

目的：通过观察冠状动脉介入诊疗术后 TR-Band 压迫止血器的不同止血策略与血管周围并发症的发生情况及舒适度情况，寻找 TR-Band 压迫止血器的最佳止血策略。方法采用前瞻性研究，将150例经桡动脉路径行冠状动脉介入诊疗术冠心病患者按数字表法随机分为三组，A 组的 TR-Band 压迫止血器初始放气时间3 h，每1小时放气1次，每次2 mL，总压迫时间10 h；B 组的 TR-Band 压迫止血器初始放气时间2 h，每2小时放气1次，每次3 mL，总压迫时间8 h；C 组的 TR-Band 压迫止血器初始放气时间1 h，每1小时放气1次，每次2 mL，总压迫时间6 h。观察并比较三组患者的拇指血氧饱和度、并发症发生情况及舒适度。结果三组压迫止血前、术后2 h 拇指血氧饱和度均正常，三组间差异无统计学意义（P ＞0．05）；A 组皮损、血肿、淤青、桡动脉闭塞发生例数分别为4、3、5、2例，B 组分别为3、4、6、1例，C 组分别为2、5、6、0例，三组皮损、血肿、淤青、桡动脉闭塞局部并发症差异无统计学意义（P ＞0．05）；三组舒适度（麻木、肿胀感、疼痛）差异均有统计学意义（F麻木＝8．215，F肿胀感＝7．657，F疼痛＝7．985，均 P ＜0．01）。结论TR-Band 压迫止血器在冠状动脉介入诊疗术后可以达到有效止血，不同的放气时间、压迫时间及每次放气量的合理调节对患者的舒适度产生一定的影响。

Objective To observe the different methods of hemostasis and comfort of the TR -Band com-pression hemostasis device after coronary intervention and to find the best strategy for TR -Band to stop the bleeding. Methods 150 patients with coronary artery disease were randomly divided into three groups according to the digital table method.The initial time of TR -Band compression hemostasis of group A was 3h,（once per hour,2mL per time,total compression time was 10h）,while that of group B was 2h（once in every two hours,3mL per time,total com-pression time was 8h）,and that of group C was 1h（once per hour,2mL per time,total compression time was 6 h）. Thumb oxygen saturation,complications and comfort level in the three groups of patients were observed and compared. Results The differences between the three groups of oppression hemostasis before and after 2 h thumb oxygen saturation were normal,the three groups had no statistical significance （P 〉0.05）.lesions,hematoma,bruising and radial artery occlusion occurred rate of group A were respectively 4,3,5,2 cases,those of group B were 3,4,6, 1 cases,and those of group C were 2,5,6,0 cases.Lesions,hematoma,bruising,radial artery occlusion of local com-plication incidence of the three groups showed no statistical significance （P 〉0.05）.The comfort level （numbness, swelling,pain）of the three groups had statistically significant differences （Fnumbness =8.215,Fswel ing =7.657,Fpain =7.985,all P 〈0.01）.Conclusion TR -Band compression hemostasis device can achieve effective hemostasis in the treatment of coronary artery intervention.And the reasonable adjustment of different bleeding time,compression time and the amount of bleeding can affect the comfort of patients.