摘要
目的 :评价经皮冠状动脉介入治疗术 (PCI)后股动脉穿刺部位应用Perclose血管缝合器止血的安全性和有效性。方法 :对 2 5 6例PCI患者进行前瞻性研究 ,所有患者均接受阿司匹林、氯吡格雷以及肝素治疗 ,动脉鞘管均为F7,一组在完成PCI后立即拔除股动脉鞘管 ,选用Perclose血管缝合器对穿刺部位动脉进行止血 ,另一组为术后 4～ 6h测活化凝血时间 <180s后拔除鞘管采用手法压迫止血。结果 :Perclose血管缝合器止血的成功率为 95 % ,两组患者的主要并发症差异无统计学意义 ,但Perclose组并发症发生率有更低的趋势 (2 3.3%∶31.6 % )。Perclose组的止血时间 (5 .1± 3.4 )min ,手法压迫组 (2 8± 10 )min ;Perclose组制动时间 (6 .4± 1.7)h ,手法压迫组 (19± 6 .5 )h。二者Perclose组均明显较手法压迫组缩短。结论 :Perclose血管缝合器是一个迅速、有效的止血方法 ,值得临床上推广。
Objective: To evaluate the safety and efficacy of percutaneous arterial suture device Perclose applied to achieve hemostasis after femoral artery access in percutaneous coronary intervention (PCI). Method:Reviewed prospectively collected data from 256 patients patient who underwent femoral artery access percutaneous coronary intervention, all patients received aspirin, clopidogrel, and heparin therapy, and Sheath size was F 7. At the treating physician's discretion, manual compression (MC) or a Perclose device was selected following PCI. Patients receiving Perclose were to have sheaths removed immediately following PCI, Patients receiving MC were to have sheaths removed 4 to 6 h postprocedure when the activated clotting time was ≤180 s. The two groups were similar regarding most demographic characteristics, including age, six, blood pressure, and weight. Result:The procedure success rate achieving hemostasis completely by Perclose device was 95%, there were no significant deference in major complication rate between two groups, however there was a downtrend in the Perclose group (Perclose 23.3% vs compression 31.6% ). Time to hemostasis (defined as the time from sheath removal to complete hemostasis) was significantly shorter in the Perclose group [( 5.1± 3.4) min with Perclose vs (28±10) min with compression], Time to ambulation was significantly shorter in the Perclose group [( 6.4± 1.7) h with Perclose vs (19± 6.5)h with compression]. Conclusion: The study demonstrates that hemostasis with Perclose device after percutaneous coronary intervention is a very fast and effective method, it can be safely and efficacy utilized to achieve hemostasis after femoral artery access in percutaneous coronary intervention.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2004年第10期586-587,共2页
Journal of Clinical Cardiology
关键词
血管缝合器
止血技术
股动脉
经皮冠状动脉介入治疗
Arterial suture device
Hemostatic techniques
Femoral artery
Percutanrous coronary intervention
