老年冠心病患者介入治疗中股动脉穿刺点三种不同止血方法应用对比研究Comparative study of three closure methods for femoral artery access site in interventional therapeutic procedures for senile patients with coronary artery disease
刘鹏,卢才义,刘玲玲,晏沐阳,李玉峰,吴兴利,王士雯
摘要(Abstract)：
目的 评价采用三种不同止血方法处理老年冠心病介入治疗患者动脉穿刺点的优缺点。方法 对 6 0例老年冠心病患者介入治疗中股动脉穿刺点采用手工压迫、Femostop器械压迫和Perclose缝合器三种方法进行处理 ,观察其所需操作时间、卧床时间、止血费用、耐受程度、操作失败率、血管迷走反射和局部血管并发症发生情况。结果 显示缝合组所需操作时间最短仅为 12min ,较手工压迫和器械止血组分别缩短约 11min和 4 3min(P <0 0 5 ) ;缝合组术后卧床时间仅需 3h左右 ,较其他两组缩短约 2 0h(P <0 0 5 ) ;患者的耐受程度优于其他两组 ,各种并发症发生率与其他方法无明显差异。结论 无创性缝合法止血迅速彻底 ,不会产生迷走神经反射 ,患者可迅速恢复活动 ,具有局部血管并发症少的优点 ,是不能耐受长时间卧床的老年冠心病患者介入手术后一种理想的局部止血方法。
关键词(KeyWords)： 冠状动脉疾病;股动脉;穿刺术;止血技术
基金项目(Foundation):
作者(Author): 刘鹏,卢才义,刘玲玲,晏沐阳,李玉峰,吴兴利,王士雯
参考文献(References)：
- 1SmithSC ,DoveJT ,KernMJ,etal.ACC AHAGuidelineforpercutaneouscoronaryinterventionexecutivesummary:areportoftheAmericanCollegeofCardiologyAmericanHeartAssociationtaskforceonpracticeguidelines.JAmCollCardiol,2001,37:22152238.
- 2卢才义.心血管介入基本工具.见:卢才义,主编.临床心血管介入操作技术.第1版.北京:科学出版社,2002.4986.
- 3KahnZM ,KumarM ,HollanderG ,etal.SafetyandefficacyofthePerclosesuture mediatedclosuredeviceafterdiagnosticandinterventionalcatheterizationsinalargeconsecutativepopulation.CatheterCardiovascInterv,2002,55:813.
- 4MehtaH ,FleischM ,ChatterjeeT ,etal.Novelfemoralarterypunctureclosuredeviceinpatientsundergoinginterventionalanddignosticcardiacprocedures.JInvasiveCardiol,2002,14:912.
- 5RinderMR ,TamirisaPK ,TaniuchiM ,etal.Safetyandefficacyofsuture mediatedclosureafterpercutaneouscoronaryinterventions.CatheterCardiovascInterv,2001,54:146151.
- 6SprouseLR ,BottaDM ,HamiltonIN .Themanagementofperipheralvascularcomplicationsassociatedwiththeuseofpercutaneoussuture mediatedclosuredevices.JVascSurg,2002,33:688693.
- 7WetterDR ,RickliH ,vonSmekalA ,etal.Earlysheathremovalaftercoronaryarteryinterventionswittheuseofsuture mediatedclosuredevice:clinicaloutcomeandresultsofDopplerUSevaluation.JVascIntervRadiol,2000,11:10331037.
- 8KornowskiR ,BrandesS ,TeplitskyI,etal.Safetyandefficacyofa6Frenchperclosearterialsuturingdevicefollowingpercutaneouscoronaryinterventions:apilotevaluation.JInvasiveCardiol,2002,14:741745.