前臂压迫止血器与传统疗法治疗TRI术后前臂血肿的比较和经验总结

Comparison of forearm compression hemostat and conventional therapy in the treatment of forearm hematoma after TRI

目的 初步探讨手工压迫法、绷带压迫法、前臂压迫止血器法和前臂压迫止血器联合脱水治疗法在治疗冠状动脉介入诊疗（TRI）术后患者出现前臂张力性血肿时的效果,为临床出现前臂血肿后进行科学处理提供依据.方法 回顾分析我科2014年4月至2016年2月TRI术后出现的334例前臂张力性血肿患者资料,按照处理方式不同,分为手工压迫组、绷带压迫组、前臂压迫止血器组和前臂压迫止血器联合脱水治疗组,对四组病例进行统计学分析,比较不同处理方法的效果差异.结果 334例前臂血肿患者中,手工压迫组（79例）与绷带压迫组（81例）相比较,肿胀消退时间、周围皮肤温度增加出现的时间、手指末端血供和功能改善为良好的出现时间及肿胀压迫后3h前臂臂围等四个主要指标比较未见统计学差异（P＞0.05）.压迫止血器组（88例）与手工压迫组和绷带压迫组之间分别比较,上述四个主要观察指标比较未见统计学差异（P＞0.05）;压迫止血器联合脱水处理组（86例）与手工压迫组和绷带压迫组之间四个主要观察指标分别比较差异有统计学意义（P＜0.05）.结论 TRI术后前臂张力性血肿的处理,人工压迫与绷带压迫效果相当,前臂压迫器能起到和手工压迫和绷带压迫一样的效果,在前臂压迫器压迫的基础上,同时积极进行脱水等综合处理,效果更加显著.

Objective Preliminary study of manual compression method, bandage compression, forearm compression hemostasis method and forearm hemostasis device combined dehydration therapy in the treatment of patients after transradial artery intervention （transradial coronary, intervention, TRI） with forearm tension hematoma, provide scientific basis for clinical treatment of forearm hematoma after TRI. Method A review of 334 cases of forearm tension hematoma were analyzed in our department in recent 6 years after TRI operation, ac- cording to the different treatment, divided into manual compression group and bandage compression group and forearm compression hemostat group, forearm compression hemostat and dehydration treatment group. The effect of processing method in the four groups were statistically analyzed and compared. Results 334 cases of forearm hematoma patients with manual compression group （79 patients） and compression bandaging group （81 patients）, swelling time, skin temperature increased around the emergence time, finger tip blood supply and improve the function of time, and swelling compression after 3H forearm arm circumference of four main indicators for the good, showed no significant difference（P〉0.05 ）. Between the compression hemostat group （88 patients ）and manu- al compression group and compression bandaging group, the four main indicators, showed no significant difference （P〉0.05）, compression hemostat dehydration treated group（ 86 patients） and manual compression group and com- pression bandaging group were compared, the four main indicators, there were significant difference （P〈0.05）. Conclusion Treatment of forearm tension hematoma after TRI operation, the artificial compression method and compression bandaging method has the same effect. The forearm compression device has the same effect like manu- al compression and bandage compression. On the basis of the forearm device oppression, and actively integrated treatment of dehydration, the effect is more significant.