抗凝和抗血小板治疗对血管缝合器有效性和安全性的影响The effects of applying percutaneous suture-mediated closure device (perclose) to the effecacy and safety after the treatment of anticoagulation and antiplatelet
李伟明,徐亚伟,陈艳清,W.Bojara,杨海燕,徐剑钢,张戟,韩雪根,范雪华
摘要(Abstract)：
目的探讨抗凝和抗血小板治疗对血管缝合器临床应用有效性和安全性的影响。方法回顾性分析抗凝和抗血小板治疗后进行冠状动脉(冠脉)造影(CAG)和或冠心病介入治疗(PCI)并采用徒手压迫或血管缝合止血的成功率、失败率以及血管并发症等。CAG组仅接受常规的抗凝和抗血小板治疗,而PCI组接受强化的抗凝和抗血小板治疗,包括术前使用噻氯匹定或氯吡格雷,术中使用肝素。结果共完成股动脉血管缝合218例,其中CAG组120例,PCI组98例,血管缝合成功率分别高达91.7%和90.8%(组间差异无统计学意义,P>0.05),均低于徒手压迫的成功率(P<0.05),而且分别有8.3%和9.2%的失败率,但其血管并发症仅见小血肿伴股动脉感染,发生率仅为1%,甚至低于徒手压迫;而且血管缝合不受是否已用抗凝剂和抗血小板药物的制约,可以在CAG和或PCI术后即刻拔鞘,止血方法简便,而且省时省力,患者也易于接受。结论常规或强化的抗凝和抗血小板治疗后应用血管缝合器即刻止血有效而安全,其血管并发症与徒手压迫相似甚至更低。
关键词(KeyWords)： 冠状血管造影术;血管成形术,经腔,经皮冠状动脉;缝合技术
基金项目(Foundation):
作者(Author): 李伟明,徐亚伟,陈艳清,W.Bojara,杨海燕,徐剑钢,张戟,韩雪根,范雪华
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