2种加压包扎法对经桡动脉冠状动脉介入治疗术后穿刺局部负性影响的比较

目的通过比较2种常用的加压包扎法对经桡动脉冠状动脉介入治疗（Transradialintervention，TRI）术后穿刺局部的负性影响，为选择合适的加压包扎法来减少穿刺局部并发症提供参考。方法所有人选患者TRI术后均即刻拔除动脉鞘管，按方便抽样的方法将患者分为两组，每组300例。A组采用自粘型弹力绷带加压包扎法，B组采用一次性使用桡动脉止血器加压包扎法。分别观察两组加压包扎法穿刺处出血发生率、穿刺处皮下血肿发生率、穿刺处周围皮肤压力伤及穿刺处疼痛程度。结果2种加压包扎法在穿刺处出血发生率方面P值〉0．05，无差异；穿刺处皮下血肿发生率一致，无差异；与A组相比较，B组穿刺处周围皮肤发红、瘀斑和水疱发生率明显减少，P值分别为〈0．005、〈0．025、〈O．005，差异有明显的统计学意义；与A组相比较，B组无痛及轻微疼痛发生率降低，但中等疼痛和强烈疼痛发生率无明显差别，P值分别为〈O．005、〈0．005、〉0．05、〉O．1。结论一次性使用桡动脉止血器加压包扎法对穿刺局部的负性影响小于自粘型弹力绷带加压包扎法。

Objective To compare the partial negative effect on puncture site after operation of two kinds of common pressure dressing methods for transradial intervention (TRI) and provide references for choosing appropriate pressure dressing method in order to reduce the complications of the punctures. Methods After immediate removal of arterial sheath pipe, all enrolled patients were divided into two groups by the convenient sampling method. Group A (300 cases) used the self-adhesive elastic bandage pressure dressing method and Group B (300 cases) used a disposable radial artery hemostat pressure dressing method. The incidence of bleeding and subcutaneous hematoma, the surrounding skin stress injury and pain degree of puncture site were observed respectively. Results There was no difference for the incidence of bleeding and subcutaneous hematoma (P>0. 05) between the two methods. Compared with Group A, there were lower incidence of the surrounding skin redness, bruises and blisters (P<0. 005, P<0. 025 and P<0. 005, respectively) in Group B and there were lower incidence of no pain and mild pain, but no differences in terms of moderate and severe pain (P<0. 005, P<0. 005, P>0. 05 and P>0. 1, respectively) . Conclusion The negative effect of one-time radial artery hemostat pressure dressing method on puncture site is less than that of the self-adhesive elastic bandage pressure dressing method.