可视化非阻塞性压迫止血在经桡动脉冠状动脉造影或介入术中的应用

Application of visualized non-obstructive compression hemostasis in performing transradial coronary angiography or interventional procedure

目的探讨经桡动脉冠状动脉造影或介入术中应用可视化非阻塞性压迫止血的效果。方法将2020年9月至12月在山东大学齐鲁医院(青岛)接受经桡动脉冠状动脉造影或介入治疗的220例患者中213例随机分为对照组(n=106)和观察组(n=107)。对照组采用常规桡动脉压迫器减压穿刺处止血治疗,观察组采用可视化指脉氧体积描记波监测下非阻塞性压迫穿刺处止血治疗。比较两组患者桡动脉压迫器压迫时长、术后1 h压迫疼痛程度、压力性损伤发生率及术后24 h桡动脉闭塞(RAO)发生率。结果观察组压迫器压迫时长显著短于对照组[(1.93±0.44)h比(9.66±0.76)h,t=91.166,P<0.001];疼痛数字评价量表(NRS)评分显著低于对照组[(0.76±0.97)分比(3.54±1.27)分,t=17.982,P<0.001];压力性损伤发生率显著低于对照组(1.87%比11.32%,χ^(2)=7.746,P=0.005),RAO发生率显著低于对照组(1.87%比14.15%,χ^(2)=10.937,P=0.001),差异均有统计学意义。结论可视化非阻塞性压迫止血可减轻患者压迫疼痛程度,降低压力性损伤和RAO发生率,且可缩短压迫器压迫时长,减少减压次数,提高医护人员工作效率。

Objective To investigate the effect of visualized non-obstructive compression hemostasis in performing transradial coronary angiography or interventional procedures.Methods A total of 213 patients,who received transradial coronary angiography or interventional treatment between September and December in 2020 at Qilu Hospital of Shandong University(Qingdao)of China,were randomly divided into control group(n=106)and observation group(n=107).Conventional radial artery compressor was used to make hemostasis of the puncture site for the patients of the control group,while under the guidance of visualized finger pulse oxygen plethysmograph wave the non-obstructive compression hemostasis of the puncture site was conducted for the patients of the observation group.The compression duration of the radial artery compressor,the postoperative one-hour pain degree,the incidence of pressure injury,and the postoperative 24-hour incidence of radial artery occlusion(RAO)were compared between the two groups.Results The compression duration in the observation group was(1.93±0.44)hours,which was significantly shorter than(9.66±0.76)hours in the control group(t=91.166,P<0.001).The NRS score in the observation group was(0.76±0.97)points,which was strikingly lower than(3.54±1.27)points in the control group(t=17.982,P<0.001).The incidence of pressure injury in the observation group was 1.87%,which was remarkably lower than 11.32%in the control group(χ^(2)=7.746,P=0.005).The incidence of RAO in the observation group was 1.87%,which was obviously lower than 14.15%in the control group(χ^(2)=10.937,P=0.001),the difference was statistically significant.Conclusion Visualized non-obstructive compression hemostasis can alleviate the compression pain degree,reduce the incidence of pressure injury and the incidence of radial artery occlusion,shorten the compression duration of the radial artery compressor,lower the frequency of decompression,and improve the working efficiency of medical staff.(J Intervent Radiol,2022,31:1078-1081)