桡动脉止血器持续使用时间对经桡动脉行冠状动脉介入治疗患者的影响

The effect of radial artery hemostat continuous compression time in patients undergoing transradial percutaneous coronary intervention

目的探讨桡动脉止血器（TrtBand）持续使用时间对经桡动脉行冠状动脉介入治疗患者穿刺点出血，术侧拇指知觉、手掌肿胀和主观舒适度的影响。方法将155例经桡动脉行冠状动脉介入治疗术后患者随机分为2个观察组和1个对照组，3组患者均使用TRBand进行伤口止血。3组术后放气方案一致，但对照组术后12h解除TRBand，观察1组术后6h解除，观察2组术后4h解除。观察3组患者的术后穿刺点出血，术侧拇指知觉、手掌肿胀程度和主观舒适度的差异。结果3组患者术后穿刺点出血、拇指知觉、手掌肿胀程度和主观舒适度的差异均有统计学意义（χ^2=6．31，F=5．26、4．00、14．69，均P〈0．05或0．01）；观察2组患者的手掌肿胀程度最低，拇指知觉、舒适度和出血率最高，观察1组各项指标的总体水平居中。结论经桡动脉介入治疗术后TRBand最佳持续使用时间为6h，既不会增加出血风险，又能改善手掌肿胀和指端的知觉体验，显著提升患者的舒适度。

Objective To investigate the effect of radial artery hemostat （TR Band） continuous compression time on bleeding of puncture point, thumb perception, palm swelling and subjective comfort in patients undergoing transradial percutaneous coronary intervention. Methods One hundred and fifty- five patients who underwent transradial percutaneous coronary intervention were randomly divided into two observation groups and a control group. All patients in the three groups were treated by TR Band patent hemostasis. All three groups received the consistent deflation schedule, except the TR Band was removed at the 12th hour post operation in the control group, and at the 6th hour in the 1st observation group and at the 4th hour in the 2nd observation group. Postoperative bleeding of puncture point, thumb perception, palm swelling and subjective comfort were observed in the three groups. Results The differences of postoperative bleeding of puncture point, thumb perception, palm swelling and subjective comfort among the three groups were statistically significant （χ^2=6.31, P〈0.05; F=5.26, 4.00, 14.69, P〈 0.01）. In the 2nd observation group, palm swelling was the lowest, but perception, and comfort and bleeding rate is the highest among the three groups. In the 1st observation group, the overall indexes were medium among the three groups. Conclusions The optimal compression duration of TR Band post transradial percutaneous coronary intervention is 6 h, which does not increase the risk of bleeding, but also significantly improve local swelling and perceptual experience, and increase patient comfort.