摘要
目的:探讨结构性心脏病患者股动脉穿刺后采用壳聚糖止血敷料协助压迫止血的效果及其相关因素。方法:将需要行股动脉穿刺实施介入操作的结构性心脏病患者随机分成试验组和对照组2组,每组100例,心导管术时均使用6F或7F动脉鞘。术后分别采用壳聚糖止血敷料加压迫止血和传统压迫止血方式进行止血,记录压迫止血时间。试验组加压包扎4 h后患者活动下肢,对照组加压包扎6 h,平卧24 h,然后下床活动,记录出血并发症。结果:试验组和对照组压迫止血时间分别为(4.0±1.5)min和(7.6±2.5)min(P<0.05),总体出血并发症分别为3%和11%(P<0.05)。试验组仅有3例出现渗血,而对照组分别出现3例渗血,4例出血和4例血肿。多元回归分析显示,在对照组中,年龄、体质量指数、血压、血小板计数和凝血酶原时间国际标准化比值对压迫止血时间无明显影响,而试验组压迫时间与血压水平呈正相关。结论:壳聚糖止血敷料可有效缩短股动脉穿刺后压迫时间,并减少出血并发症。
AIM：To evaluate the efficacy and safety of chitosan dressings used for femoral hemostasis as an adjunct to manual compression in patients with structural heart disease undergoing cardiac catheterization.METHODS：Two hundred patients with structural heart disease undergoing cardiac catheterization were 1 ∶1 randomized for manual compression using regular or chitosan dressings.All patients were catheterized with a 6 Fr or 7 Fr sheath.Time to achieve hemostasis and incidence of minor and major bleeding were compared between groups.RESULTS：Time to achieve hemostasis was（4.0±1.5） and（7.6±2.5） min and the incidence of minor and major bleeding was 3% and 11%,respectively,in chitosan and regular dressings groups（P0.05）.Errhysis developed in 3%,and 3% of patients,respectively,in chitosan and regular dressings groups,but hematoma（n=4） and bleeding（n=4） were only observed in regular dressings group.Multiple regression models showed that the time to hemostasis was not associated with age,body mass index,blood pressure,blood platelet count and international normalized ratio in regular dressings group but was positively associated with mean blood pressure in chitosan dressings group.CONCLUSIONS：Compared with regular dressings,chitosan dressings significantly decrease the time to achieve hemostasis and lower the total incidence of hemorrhage.
出处
《心脏杂志》
CAS
2012年第1期84-87,共4页
Chinese Heart Journal
关键词
止血
动脉
壳聚糖
心脏病
结构性
hemostasis
artery
chitosan
structural heart disease
