瞬灵动脉止血敷料压迫止血在肝癌TACE患者的临床应用与效果研究

Compression hemostasis with Shunlin arterial hemostatic dressing for patients with hepatocellular carcinoma after transcatheter arterial chemoembolization: its clinical application and efficacy

目的评价瞬灵动脉止血敷料压迫止血在肝癌TACE患者的临床应用效果。方法将符合纳入标准的肝癌TACE患者分成两组,观察组96例采用瞬灵动脉止血敷料压迫止血,对照组97例采用改良"8字型"纱布绷带包扎止血,观察两组在局部淤青、局部血肿、重新包扎、局部皮损、对患者舒适度、睡眠、活动的影响以及压迫包扎时间、卧床制动时间的差异性。结果两组患者在局部淤青、局部血肿、重新包扎、局部皮损发生方面差异无统计学意义(P>0.05);两组患者在不舒适、影响睡眠和活动症状困扰评分方面观察组显著小于对照组,差异有显著统计学意义(P<0.01);在压迫包扎时间、肢体制动时间、包扎拆除时间和卧床时间,观察组分别为(3.38±0.57)min、(6.07±0.28)h、(6.08±0.36)h和(12.34±0.93)h,显著少于对照组(10.52±1.16)min、(7.89±0.36)h、(12.12±0.66)h和(23.77±0.87)h,差异有显著统计学意义(P<0.001)。结论瞬灵动脉止血敷料压迫止血具有对股动脉穿刺点快速止血、改善患者术后舒适度、缩短卧床制动时间的作用,且不增加穿刺局部并发症发生率,是一种安全有效的压迫止血方法,值得临床推广。

Objective To evaluate the clinical effect of compression hemostasis with Shunlin arterial hemostatic dressing in transcatheter arterial chemoembolization(TACE) for patients with hepatocellular carcinoma(HCC). Methods A total of 193 HCC patients who met the inclusion criteria were divided into study group(n=96) and control group(n=97). Compression hemostasis with Shunlin arterial hemostatic dressing was adopted for the patients of the study group, while modified "8-shaped" gauze bandage dressing hemostasis was employed for the patients of the control group. The local bruising, local hematoma, re-bandaging, local skin lesions, patient’s comfortableness degree, sleeping quality, daily activity, time of compression dressing hemostasis, and time of limbs and trunk immobilization were compared between the two groups. Results No statistically significant differences in local bruising, local hematoma, re-bandaging, local skin lesions existed between the two groups(P>0.05). The evaluation scores of uncomfortable degree, poor sleeping and daily activity dysfunction in the study group were remarkably lower than those in the control group, the differences were statistically significant(P<0.01). The time of compression dressing hemostasis, time of limbs and trunk immobilization, time of bandage removal and time rest in bed in the study group were(3.38±0.57) min,(6.07±0.28) h,(6.08±0.36) h and(12.34±0.93) h respectively, which were obviously less than(10.52±1.16) min,(7.89±0.36) h,(12.12±0.66) h and(23.77±0.87) h respectively in the control group, the differences were statistically significant(P<0.001). Conclusion For hemostasis of femoral artery puncture point in TACE, the effect of compression hemostasis with Shunlin arterial hemostatic dressing is quickly effective. This technique carries several advantages such as improving postoperative patient’s comfortableness degree, shortening the time of limbs and trunk immobilization and not increasing the incidence of local complications at puncture site, and it is a safe and effective method of compression hemostasis. Therefore, this technique is worthy of clinical promotion.(J Intervent Radiol, 2021, 30: 519-522)