脑血管介入术后穿刺血管局部血管缝合器压迫时间的临床观察

Compression time of vascular closure device for local puncture vessels after cerebrovascular intervention

目的探讨脑血管介入术后穿刺血管局部血管缝合器不同压迫时间的临床效果。方法收集2020年1月至2021年6月四川大学华西医院/四川大学华西护理学院收治的行脑血管支架植入术的123例脑梗死患者临床资料,根据术后血管缝合器压迫时间的不同将患者分为A组(术后6 h取3 M加压固定胶带)、B组(术后9 h取3 M加压固定胶带)和C组(术后12 h取3 M加压固定胶带),每组41例。观察3组患者的并发症发生情况,并比较术后6 h、12 h、24 h 3组患者的舒适度、疼痛感及焦虑情况。结果术后6 h,A组患者的舒适度评分高于B组、C组患者(P<0.05);术后12 h,A组和B组患者的舒适度评分均高于C组患者(P<0.05);术后24 h,3组患者的舒适度评分比较,差异无统计学意义(P>0.05)。术后6 h,A组患者的疼痛评分低于B组、C组患者(P<0.05);术后12 h,A组、B组患者的疼痛评分均低于C组患者(P<0.05);术后24 h,3组患者的疼痛评分比较,差异无统计学意义(P>0.05)。术后12 h,A组患者的焦虑评分低于B组和C组患者(P<0.05);术后6 h、24 h,3组患者的焦虑评分比较,差异均无统计学意义(P>0.05)。3组患者出血、血肿、腰背痛的发生率比较,差异均无统计学意义(P>0.05);3组患者医用粘胶相关性皮肤损伤(MARSI)的发生率比较,差异有统计学意义(P<0.05)。结论脑血管介入术后穿刺血管局部时,采用血管缝合器止血效果较好,术后6 h取3 M加压固定胶带可以提高脑梗死患者的舒适度,减轻患者的疼痛感,且不会增加出血风险。

Objective To explore the clinical effect of different compression time of vascular closure device for local puncture vessels after cerebral vascular intervention.Method The clinical data of 123 patients with cerebral infarction undergoing cerebrovascular stent implantation in West China Hospital,Sichuan University/West China School of Nursing from January 2020 to June 2021 were collected.According to the compression time of vascular suture device after operation,patients were divided into group A(3 M fixing tape was removed at 6 h after surgery),group B(3 M fixing tape was removed at 9 h after surgery)and group C(3 M fixing tape was removed at 12 h after surgery),with 41 cases in each group.The complications in the three group was observed.Comfort levels,pain and anxiety at 6 h,12 h and 24 h after surgery were compared.Result At 6 h after surgery,the comfort scores of group A were higher than those of group B or group C(P<0.05).At 12 h after surgery,the comfort scores of group A and group B were higher than those of group C(P<0.05).There was no statistically significant difference in comfort scores among the three groups at 24 h after surgery(P>0.05).At 6 h after surgery,the pain scores of group A were lower than those of group B or group C(P<0.05).At 12 h after surgery,the pain scores of group A and group B were lower than those of group C(P<0.05).There was no statistically significant difference in pain scores among the three groups at 24 h after surgery(P>0.05).At 12 h after surgery,the anxiety scores of group A were lower than those of group B or group C(P<0.05).There was no statistically significant difference in anxiety scores among the three groups at 6 h and 24 h after surgery(P>0.05).There was no significant difference for the incidence of bleeding,hematoma,and low back pain among the three groups(P>0.05),but there were statistically significant differences in the incidence of medical adhesive-related skin injury(MARSI)(P<0.05).Conclusion Vascular closure device can achieve better hemostatic effect on local puncture vessels after cerebral vascular intervention.Removing the 3 M fixing tape at 6 h after surgery can improve comfort level and alleviate pain of the patients,without increasing the risk of bleeding.