8字缝合技术处理股动脉穿刺隧道渗血的临床研究

Efficacy of figure 8 suturing technique in treatment of tunnel bleeding after femoral artery puncture

目的评估8字缝合技术在处理股动脉穿刺点隧道渗血中的作用。方法连续纳入解放军总医院心血管内科行股动脉穿刺介入诊治术后出现穿刺隧道渗血现象的患者152例,随机分为2个处理组:8字缝合组(63例)和加压包扎组(89例),比较2组5个指标的差异,包括平均压迫时间、包扎次数、平均操作时间、下肢静脉血栓发生率及术后平均住院时间。使用SPSS 22.0统计软件处理,依据数据类型分别采用成组t检验或卡方检验进行组间比较。结果 8字缝合组的5项指标均优于加压包扎组:平均压迫时间(22.3±5.4)vs(26.8±6.8)h、包扎次数(2.1±0.7)vs(2.6±1.1)次、平均操作时间(8.9±2.5)vs(12.3±4.1)min、下肢深静脉血栓发生率0.0%vs 6.7%、平均术后住院时间(3.5±1.2)vs(4.8±2.1)d,且差异具有统计学意义(P<0.05)。结论 8字缝合技术处理股动脉穿刺隧道渗血简单有效,明显优于传统加压包扎的处理方法。

Objective To evaluate the efficacy of figure 8 suturing technique in treatment of tunnel bleeding after femoral artery puncture.Methods A total of 152 patients,who had undergone transfemoral percutaneous coronary intervention and then developed bleeding after catheter insertion,admitted in our department from December 2013 to December 2016 were enrolled in the study consecutively.These patients were assigned randomly into figure 8 suturing group(n=63)and strengthened compression group(n=89).Five parameters,including mean compression time,bandaging frequency,mean operation time,incidence rate of lower limb deep vein thrombosis(DVT),and length of hospital stay after operation,were compared between the 2 groups.SPSS statistics 22.0 was used to perform the statistical analysis,and Student′s t test or Chi-square test was employed to make comparison for different data types.Results Compared to the strengthened compression group,the figure 8 suturing group had shorter compression time[(22.3±5.4)vs(26.8±6.8)h,P<0.01],less bandaging frequency[(2.1±0.7)vs(2.6±1.1)times,P<0.01],shorter operation time[(8.9±2.5)vs(12.3±4.1)min,P<0.01],lower incidence rate of DVT(0.0%vs 6.7%,P<0.05),and shorter length of hospital stay[(3.5±1.2)vs(4.8±2.1)d,P<0.01].Conclusion Figure 8 suturing technique is effective and easy-to-operate in treatment of tunnel bleeding after femoral artery puncture,and obviously superior to conventional compression method.