ProGlide缝合与手动压迫止血在VA-ECMO中的疗效比较

Comparison of ProGlide suture and manual compression hemostasis in VA-ECMO

目的比较静脉-动脉(veno-arteial,VA)体外膜肺氧合(extracorporealmembrane oxygenation,ECMO)患者股动脉置管术后手动压迫止血和ProGlide血管缝合器止血方式的安全性、有效性及可行性。方法回顾性分析湖南省岳阳市中心医院2015年11月至2023年06月收治的需行股动脉置管的VA-ECMO患者,撤管时应用手动压迫止血或ProGlide血管缝合器止血。结果最终纳入47例行VA-ECMO治疗患者,其中手动压迫止血组24例,ProGlide血管缝合器组23例。结果发现手动压迫组止血时间(61.67±6.16)min显著长于ProGlide血管缝合器组(15.04±2.75)min。手动压迫止血组制动时间(23.92±1.56)h,显著长于ProGlide血管缝合器组(6±0)h,且相关并发症方面无显著差异。结论VA-ECMO患者股动脉手动压迫止血和ProGlide血管缝合器止血安全性与有效性无显著差异,但血管缝合器在总住院费不变的前提下,能够缩短止血时间及下肢制动时间,可行性更高。

Objective To compare the safety,efficacy,and feasibility of manual compression hemostasis and the ProGlide vascular stapler in patients undergoing veno-arterial(V-A)extracorporeal membrane oxygenation(ECMO)with femoral artery catheterization.Methods This study retrospectively analyzed VA-ECMO patients who required femoral artery catheterization hospitalized in Yueyang Central Hospital of Hunan Province from November 2015 to June 2023,and stopped bleeding with manual compression or ProGlide vascular stapler after duct withdrawal.Results The study included a cohort of 47 patients who underwent treatment with VA-ECMO.The results revealed a statistically significant difference in hemostasis time between the manual compression group(61.67+6.16)minutes and the ProGlide vascular stapler group(15.04±2.75)minutes.Furthermore,the immobilization time in the manual compression hemostatic group(23.92±1.56 hours)was significantly longer compared to the ProGlide vascular stapler group(6±0)hours.However,there were no significant differences observed in terms of related complications.Conclusions There is no significant difference in safety and efficacy between manual femoral artery compression hemostasis and ProGlide vascular stapls in VA-ECMO patients,and vascular staplers have stronger feasibility by shortening the hemostasis time and lower limb immobilization time without increasing the total cost of hospitalization.