神经介入术股动脉穿刺点并发症影响因素分析

Analysis of Risk Factors of Femoral Artery Puncture Site Complications after Neuroendovascular Treatment

目的探讨神经介入术后患者股动脉穿刺点并发症发生的危险因素。方法回顾性分析2019年3-9月首都医科大学附属北京天坛医院神经介入中心收治的经股动脉穿刺进行神经介入治疗的患者,对穿刺点并发症(包括穿刺点渗血、皮下血肿、腹膜后血肿、假性动脉瘤、下肢动静脉瘘等)发生的影响因素进行单因素和多因素分析。结果本组纳入患者共1240例,发生穿刺点并发症76例(6.13%),无并发症1164例(93.87%)。单因素分析显示男性、股动脉采用缝合器处理、穿刺部位使用压迫器和术后高血压与穿刺点并发症发生相关。多因素分析显示,股动脉采用缝合器处理(OR 2.371,95%CI 1.467~3.831,P=0.001)、穿刺部位使用压迫器(OR 2.183,95%CI 1.268~3.760,P=0.005)和术后高血压(OR 1.778,95%CI 1.004~3.151,P=0.049)是穿刺点并发症的独立危险因素。结论对于接受经股动脉血管内介入治疗的患者,股动脉采用缝合器处理、穿刺部位使用压迫器和术后高血压是穿刺点并发症的独立危险因素。

Objective To explore the clinical risk factors of postprocedural femoral artery puncture site complications in patients who received neuroendovascular therapy.Methods Patients who received neuroendovascular therapy through femoral artery puncture in Neurointervention Center,Beijing Tiantan Hospital,Capital Medical University from March to September 2019 were retrospectively analyzed.A multivariate analysis was used to analyze the clinical risk factors of puncture site complications,including errhysis,subcutaneous hematoma,retroperitoneal hematoma,pseudoaneurysm,and arteriovenous fistula of the lower extremities.Results A total of 1240 patients were enrolled in the study,including 76 cases(6.13%)with complications and 1164(93.87%)cases without complications.The univariate analysis showed male,femoral artery suture,use of compressor,and postoperative hypertension were correlated with the complications.The multivariate analysis showed femoral artery suture(OR 2.371,95%CI 1.467-3.831,P=0.001),use of compressor(OR 2.183,95%CI 1.268-3.760,P=0.005),and postoperative hypertension(OR 1.778,95%CI 1.004-3.151,P=0.049)were independent risk factors for puncture site complications.Conclusions For patients who underwent interventional therapy via femoral artery access,femoral artery suture,use of compressor and postoperative hypertension were independent risk factors for puncture site-related complications.