无肝素冠脉造影术后股动脉止血方法的探讨.docVIP

【摘要】 目的：评价无肝素股动脉冠状动脉造影术(CAG)后股动脉穿刺部位应用改良加压包扎法止血的效果和安全性。方法：经股动脉途径行CAG的120例患者,分为两组,A组术后采用Angio-seal装置止血,B组采用改良加压包扎法止血,两组抗血小板治疗相同,比较两组止血时间、止血成功率、开始活动时间、并发症和患者的舒适度。结果： ①两组止血的成功率（均为100%），制动时间［ A组为(3.6±0.7)h, B组(3.8 ±0.5)h］,舒适度均无显著差异(P＞0.05); ②止血时间［A组(2.1±0.8)min, B组 (7.5±2.8)min］,加压包扎时间［A组0 h, B组为(10.2 ±2.3)h］, A组显著短于B组(P0.05)；③主要并发症: 血肿发生率A组（11.7%）显著多于B组（3.3%），P0.05。结论：无肝素股动脉冠状动脉造影术后股动脉穿刺部位应用改良加压包扎法止血效果好,价格低廉,并发症少,值得临床推广。 【关键词】 止血技术；股动脉;冠状血管造影术 Research on hemostasis of femoral arterial after nonheparin coronary angiography/FU Yan，ZHANG Yuan|chun,YIN Qing，WU Jia|kuan，DAI Lei//Chinese Journal of Cardiovascular Rehabilitation Medicine,2009，18（2）:164 Abstract：Objective:To estimate the hemostasis efficiency and safety of the improved pressure dressing after trans-femoral coronary angiography.Methods:A total of 120 patients who received transfemoral coronary angiography were randomly divided into two groups: group A and group B. The femoral artery puncture points of patients in group A were closed by Angioseal vascular closure device, while the improved pressure dressing was used to stop bleeding in group B. Both groups took same dose of antiplatelet drugs.Results: (1) The hemostasis efficiency （100% all two group）, lower limb activity time［group A(3.6±0.7)h, group B(3.8 ±0.5)h］,and the degree of comfort （all objects did not felt obviously uncomfortable）of both groups were no significant difference(P＞0.05);(2)The hemostasis time ［group A(2.1±0.8)min, group B (7.5±2.8)min］ and pressure dressing time ［groupA 0 h,group B(10.2 ±2.3)h］ of group A were less than those of group B (P0.05)；(3)The incidence rate of main complications：Incidence of haematoma in group A was more than that of group B，P0.05。Conclusion:Applying the improved pressure dressing to stop bleeding after transfemoral coronary angiography is as same efficient as Angioseal vascular closure device, but has less cost and lower incidence rate of main complications. So it is a valuable method to gene