老年冠状动脉介入诊疗术后Perclose血管缝合的临床作用

目的评价老年冠状动脉(简称冠脉)介入诊疗术后Perclose血管缝合止血的安全性和临床效果。方法204例老年冠脉介入诊疗术后患者,97例应用Perclose缝合器止血(称缝合组),107例应用手工压迫止血方法止血(称对照组)。分别记录止血时间、下肢制动时间和手术相关并发症。结果缝合组:缝合成功率92.8%;止血时间1.9±1.2min;下肢制动时间4.0±0.9h;并发症发生率为3.1%。对照组:一次止血成功率93.5%;止血时间27.5±10.5min;下肢制动时间22.0±4.3h;手术相关并发症发生率为18.7%。统计学处理显示:缝合组与对照组的止血成功率无显著性差异(χ2=1.16,P>0.05);缝合组的止血时间和下肢制动时间明显较对照组缩短(t止血=17.3熏t制动=29.3熏P<0.01);对照组手术相关并发症发生率明显高于缝合组(χ2=8.7熏P<0.01)。结论用Perclose血管缝合器处理老年冠脉介入诊疗术后穿刺血管安全有效,与手工压迫止血比有以下优点:①止血时间和下肢制动时间明显缩短,减少了因制动给患者带来的不适;②明显减少手术相关并发症的发生。缺点:Perclose血管缝合的直接费用较高。

Clinical application of the suture hemostasis device Perclose after coronary interventional procedure for senile patients

Objective To evaluate the safety and efficacy of the suture hemostasis device Perclose after coronary interventional procedure in the elderly. Methods The 204 elderly patients who underwent coronary interventional procedure were divided into two groups: 97 patients accepted Perclose device for hemostasis(the suture group); 107 patients accepted manual method for hemostasis(the control group). Times to successful hemostasis, times to crura ambulance, and complications associated with the proce-dure were recorded.Results The rates of successful hemostasis were 92.8% in the suture group and 93.5% in the control group( Times to successful hemostasis were (1.9 in the suture group and (27.5 in the control group(t=17.3,P<0.01); times to ambulation were (4.0 vs (22.0 in the suture and control groups respectively(t=29.3,P<0.01). The occurence rates of complication were 3.1% vs 18.7% in the suture group and control group respectively( Conclusion Perclose suture device is safe and effective for hemostasis of the femoral access site after coronary interventional procedure in elderly patients. The benefit compared with the control group was as following: (1)Times to successful hemostasis and to crura ambulation were shorter than the control group. The patients′discomfort from the crura motionless were decreased.(2)The occurence rate of complication was decreased significantly. The disadvantage is too expensive.