2020冠脉造影术后常规处理.pptVIP

Routine management after coronary angiography Beijing Anzhen Hospital 防治措施： ? 禁食 4-6h ? 必要时局麻，避免疼痛 ? 压迫止血前，保持静脉通道 ? 压力适当 Ilia R, Cathet Cardilvasc Diagn, 1997,40(3):336 Routine management after coronary angiography Beijing Anzhen Hospital 血管并发症 ? 出血和血肿 ? 髂、股动脉夹层 ? 假性动脉瘤 ? 动静脉瘘 Routine management after coronary angiography Beijing Anzhen Hospital 出血和血肿 Routine management after coronary angiography Beijing Anzhen Hospital 出血和血肿 ? 发生率：严重者 0.1% ? 处理： ? 少量出血或小血肿，不予特殊处理 ? 血肿太大伴失血过多引起血压下降者，需重新包扎、补液 ? 低血压伴下腹部腰腹部疼痛者，立即行腹部 CT 明确有无腹 膜后血肿，如有则应立即停用抗凝及抗血小板药物，补液 输血，必要时请外科处理 Routine management after coronary angiography Beijing Anzhen Hospital 髂、股动脉夹层 ? 预防及处理： ? 穿刺时刺入时可见喷射血流，而回撤时无血流，多为 穿刺针刺入动脉前壁夹层，与刺穿股动脉相反，此时 切忌实验性注射造影剂，以免夹层撕裂 Routine management after coronary angiography Beijing Anzhen Hospital 6F Angioseal 锚在 9mm 血管内 锚 =3.1% 血管横截面 Routine management after coronary angiography Beijing Anzhen Hospital 6F Angioseal 锚在 6mm 血管内 锚 =7.0% 血管横截面 Routine management after coronary angiography Beijing Anzhen Hospital Angioseal 操作步骤： 1. 准备 Routine management after coronary angiography Beijing Anzhen Hospital 2. 送鞘 Routine management after coronary angiography Beijing Anzhen Hospital 3.1 释放“锚” —— 安全帽与输送鞘咬合 ——“ 锚”伸 出 Routine management after coronary angiography Beijing Anzhen Hospital 3.2 释放“锚” —— 安全帽锁止 ——“ 锚”定 位 Routine management after coronary angiography Beijing Anzhen Hospital 4.1 闭合穿刺点 Clear stop 压缩标记 调节杆 Routine management after coronary angiography Bei