老年患者冠状动脉造影术后不同股动脉止血方法的效果比较

目的：评价冠状动脉造影及经皮冠状介入治疗术后老年患者股动脉穿刺部位不同止血方法的效果及安全性.方法：268例行冠状动脉造影及经皮冠状动脉介入治疗的老年患者,平均年龄63.8岁,根据不同股动脉止血方法分为3组.A组82例采用徒手压迫法止血 B组87例采用M-GU动脉压迫器止血 C组99例采用Angio血管闭合器止血.比较3组患者术后制动时间、止血效果及术后并发症发生率.结果：A组止血成功率为98.8%（81/82例）,B组为97.7%（85/87例）,C组为96.0%（95/99例）,3组间差异无统计学意义（P＞0.05）.止血和制动时间比较,C组（4.3±1.1）min和（4.9±0.9）h]少于B组（6.2±1.2）min和（12.2±1.5）h],B组少于A组（23.2±3.6）min和（25.7±2.3）h].并发症的发生情况：3组间局部渗血和假性动脉瘤的发生率差异无显著性 尿潴留和腰痛并发症的发生率差异存在显著性,C组（2.0%和7.1%）低于A组（14.6%和42.7%）和B组（6.9%和20.7%）.结论：3种止血方法的止血效果无差异,但是应用血管闭合器止血可以有效缩短老年患者止血时间及下肢制动时间,减少并发症发生,患者易于接受.

Comparison of the effect of different ways of femoral hemostasis in senile patients after coronary artery angiography

Objective.. To evaluate the hemostatic effects and safety by using artificial compression for hemostasis, M-GU artery compressor, and Anglo seal on the locations of femoral puncture in senile patients who underwent coronary artery angiography （CAG） or percutaneous coronary intervention operation. Methods：Two hundreds and sixty-eight senile patients（63.8 years old in average） who underwent percutaneous coronary intervention operation were divided into three groups. In group A, 82 patients were treated with hand compression hemostasis. In group B, 87 patients were treated with artery compressor. In group C, 99 patients were treated by using anglo seal hemostasis. The restriction time, the effect of hemostasis and the complications among three groups were compared. Results：The success rate of hemostasis was 98.8% （81/82 cases） in group A, 97.7% （85/87 cases）in group B, 96.0 % （95 / 99 cases） in group C, and the differences were not significant among the 3 groups （P〉 0.05）. The time of hemostasis and restriction time in group C （4.3 ±2.1）minutes and（4.9±1.8） hours] were shorter than group B （6.2±1.2）minutes and （12.2±1.5）hours], and the latter was shorter than group A（23.2±3.6） minutes and （25.7±2.3）hours]. The incidence of complications, including local blood oozing and false aneurysm were similar, but the incidence of urinary retention and lumbago was lower in group C （2.0% and 7.1%） than group A （14.6% and 42.7%） and group B （6.9% and 20.7% ,P〈0.05）. Conclusion：The effect of hemostasis is similar in the 3 groups, but the use of vessel sealer can effectively reduce the time of hemostasis and restriction time for senile patients and reduce the risk of complication.