TR-Band止血器在经皮冠状动脉介入诊疗中的应用效果

Application effect of TR-Band hemostat in diagnosis and treatment of percutaneous coronary intervention

目的 比较桡动脉穿刺术后传统绷带和TR-Band止血器压迫方法的效果。方法 选取2013年6月~2015年3月在我院经桡动脉途径进行PCI的患者580例进行回顾性对比分析,按照包扎方法分为绷带组（290例）和TR-Band止血器组（290例）,观察两组的止血成功率、压迫止血总时间、包扎止血操作时间、远端肿胀消退时间、术后2 d内出血、轻度皮下淤血、压迫后指端血氧饱和度,局部皮肤破损坏死、桡动脉闭塞、迷走神经反射、前臂疼痛或压痛情况,术后至出院时间。结果 绷带组有12例一次止血失败,出现出血及渗血,TR-Band止血器组止血全部成功,无术后出血及渗血情况,两组比较,差异有统计学意义（P=0.0008）;绷带组操作时间、术后压迫止血总时间、术后远端肿胀消退时间明显比TR-Band止血器组长（P〈0.01）;绷带组术后2 d内出血及轻度皮下淤血发生率较TRBand止血器组高（P〈0.01）;两组的术后指端血氧饱和度、前臂疼痛或压痛、术后至出院时间比较,差异无统计学意义（P〉0.05）。两组均未发生桡动脉闭塞、迷走神经反射、局部皮肤破损坏死。结论 与传统绷带加压包扎方法相比,TR-Band止血器在经桡动脉冠状动脉介入诊疗后止血中的效果可靠,并发症发生率低。

Objectlve To compare the effect of traditional bandage and TR-Band hemostat for compression after radial artery puncture.Methods 580 patients given transradial approach for percutaneous coronary intervention by our hospital from Jurie 2013 to March 2015 were selected for retrospective comparative analysis and according to the dressing method,the subjects were divided into bandage group （290 cases） and TR-Band hemostat group （290 cases）.The following indexes were observed：successful rate of hemostasis,the total time of hemostasis by compression,operation time of hemostasis by dressing,regression time of distal swelling,postoperative bleeding in two days,mild subcutaneous congestion, finger tip blood oxygen saturation after compression,damage and necrosis of local skin,radial artery occlusion,vagus reflex,pain or tenderness of forearm, pain or tenderness,and time to discharge after surgery in two groups was observed respectively.Results In bandage group, there were 12 cases failed in one time having bleeding and errhysis while in TR-Band hemostat group,hemostasis was entirely successful aving no bleeding and errhysis,then there was a statistical difference between two groups （P=0.0008）.Operation time,the total time of hemostasis by compression after operation, regression time of distal swelling after operation in bandage group was obviously longer than that of TR-Band hemostat group respectively （P〈0.O1）.Incidence rate of postoperative bleeding in two days,mild subcutaneous congestion in bandage group was obviously higher than that of TR-Band hemostat group respectively （P〈0.01）.There was no statistical difference of finger tip blood oxygen saturation after surgery,pain or tenderness of forearm and time to discharge after surgery between two groups （P〉0.05）.There was no radial artery occlusion,vagus reflex,pain or tenderness of forearm,damage and necrosis of local skin in two groups.Conclusion Compared with hemostasis effect of TR-Band hemostat is reliable in hemostasis intervention,and incidence rate of complication is lower. compression dressing method of traditional bandage, after transradial approach for percutaneous coronary.