老年冠心病患者介入治疗中股动脉穿刺点三种不同止血方法应用对比研究

目的　评价采用三种不同止血方法处理老年冠心病介入治疗患者动脉穿刺点的优缺点。方法　对 6 0例老年冠心病患者介入治疗中股动脉穿刺点采用手工压迫、Femostop器械压迫和Perclose缝合器三种方法进行处理 ,观察其所需操作时间、卧床时间、止血费用、耐受程度、操作失败率、血管迷走反射和局部血管并发症发生情况。结果　显示缝合组所需操作时间最短仅为 12min ,较手工压迫和器械止血组分别缩短约 11min和 4 3min(P <0 0 5 ) ;缝合组术后卧床时间仅需 3h左右 ,较其他两组缩短约 2 0h(P <0 0 5 ) ;患者的耐受程度优于其他两组 ,各种并发症发生率与其他方法无明显差异。结论　无创性缝合法止血迅速彻底 ,不会产生迷走神经反射 ,患者可迅速恢复活动 ,具有局部血管并发症少的优点 ,是不能耐受长时间卧床的老年冠心病患者介入手术后一种理想的局部止血方法。

Comparative study of three closure methods for femoral artery access site in interventional therapeutic procedures for senile patients with coronary artery disease

Objective To evaluate the merits and demerits of three different closure methods for femoral artery access site in the interventional therapeutic procedures for senile patients with coronary artery disease. Methods We managed the femoral artery access sites in 60 cases undergoing interventional operation using three different hemostasias, including manual compression, Femostop equipment and Perclose suture (20 cases for each group). The procedure time, time for patients staying in bed, expenditure obedience, the percentage of procedure failure and vagal vascular reflex, and local vascular complications were observed and analyzed statistically. Results The study showed that the procedure time in Perclose suture group was about 12 minutes, much shorter than that in finger pressing and Femostop equipment groups (respectively 23 and 55 minutes, P<0.05). The patients in Perclose suture group just needed around 3 hours to stay in bed, shortening about 20 hours more than the other groups (both P<0.05). The obedience of patients in Perclose suture group was also better than others. There was no significant difference in vascular complications. Conclusion Perclose suture could stanch femoral artery access site thoroughly and not cause vagal vascular reflex. Patients accepting this hemostasia had less local vascular complications and reactivated sooner. It is an ideal local hemostasia for the patients undergoing interventional therapeutic procedures but not bearing to stay in bed for a long time.