冠脉介入术后Angioseal血管缝合与压迫止血的对比研究

Comparison of Angioseal closure device with manual compression in patients undergoing angiograph and angioplasty.

目的 评价Angioseal缝合器止血的实用性。方法 2 0 0 2 - 10～ 2 0 0 3- 0 7所做的冠状动脉造影或介入治疗病例共 2 6 0例 ,其中冠状动脉造影 15 0例 ,介入治疗 110例。按止血方法不同分为传统压迫止血组和血管缝合组。结果 (1)缝合法与压迫法止血时间及下肢制动时间的比较。单纯冠状动脉造影止血时间分别为 :缝合法(1 8± 0 9)min ,压迫法 (2 5 3± 13 4 )min ,两者差异有非常显著性 (P <0 0 0 1) ;下肢制动时间分别为 :缝合法 (3 8± 0 8)h ,压迫法 (13 4± 2 2 )h ,两者差异有非常显著性 (P <0 0 0 1) ;介入治疗后止血时间 :缝合法与压迫法分别为 (2 0± 1 1)min及 (2 9 5± 14 3)min ,两者差异有非常显著性 (P <0 0 0 1) ;下肢制动时间缝合法与压迫法分别为(4 3± 1 5 )h及 ,(2 4 3± 3 2 )h ,两者差异有非常显著性 (P <0 0 0 1)。 (2 )压迫法术后各类并发症如出血、血肿、迟发出血 (第 3天以后 ,至 1周 )、迷走反射、皮肤溃烂等 ,明显高于缝合法 (P <0 0 0 1)。结论 Angioseal缝合器止血简便、实用、安全。

Objective To assess the safety and efficiency of Angioseal device in patients undergoing coronary percutaneous procedure.Methods A prospective trial was carried out in 260 patients undergoing angiograph and angioplasty during october 2002 to July 2003.All patients were divided into two groups: Angioseal closure device and manual compression.Results In angiography,the time to hemostasis was (1.8±0.9)min by Angioseal and (25.3±13.4)min by manual compression(P<0.01).Ambulation time was (3.8±0.9)h by Angioseal and (13.4±2.2)h by manual compression(P<0.01).In angioplasty,the time to hemostasis was (2.0±1.1)min by Angioseal and (29.3±14.3)min by manual compression(P<0.01).Ambulation time was (4.8±1.5)h by Angioseal and (24.3±3.2)h by manual compression(P<0.01).Manual compression had higher complication rate than Angioseal.Conclusion Angioseal closure device is safe,efficient and easy to use.