压力递减压迫止血法在经股动脉介入治疗术后的应用

目的 探讨经股动脉介入治疗术后有效、安全的压迫止血方法。方法 将86例经股动脉介入治疗术后患者随机分为传统组（50例）与改进组（36例）。传统组采用常规压迫止血法，改进组采用一次性股动（静）脉气囊压迫止血带进行压力递减压迫止血。观察两组术肢制动时间、血管并发症及不良反应。结果改进组术肢制动时间厦血管并发症，腰酸、腹胀发生率显著低于传统组（P〈0．01，P〈0．05）。结论经股动脉介入治疗术后通过压力递减法进行压迫止血。既可达到有效压迫止血的目的，又能减少传统压迫止血所致的不良反应。     

气囊压迫止血在冠状动脉介入诊疗术后的应用

目的观察气囊压迫止血在冠状动脉介入诊疗术后的应用效果,减少局部并发症的发生。方法将506例经股动脉穿刺行冠状动脉诊疗术的患者随机分为对照组（224例）和观察组（282例）,对照组术后穿刺点用弹力胶布固定,沙袋压迫止血;观察组用自制气囊压迫止血。观察两组止血效果、局部并发症发生率和术侧肢体舒适度。结果观察组出血2例（0.7%）,无局部并发症发生,30例（10.6%）患者诉术侧肢体麻木;对照组出血190例（84.8%）,131例（58.5%）局部皮肤发生并发症,219例（97.8%）诉术侧肢体麻木,两组比较,差异有显著性意义（均P〈0.01）。结论气囊压迫止血对冠状动脉介入术后止血效果显著,减少了局部并发症的发生,增进了患者舒适感。     

改良式髋关节支具在经股动脉穿刺介入术后的应用

目的提高经股动脉穿刺介入术后患者舒适度,并降低术后相关并发症。方法对髋关节支具进行改良,并应用于20例经股动脉穿刺介入术患者,通过固定髋关节使之保持伸直状态,即用腰部绑带、腿部绑带分别将腰部固定器、腿部固定器固定在腰部和腿上,调节好上、下支撑杆,使其固定和不可扭转,然后用弹性绑带交叉固定沙袋,松紧以可以触及足背动脉搏动为宜。结果 20例患者使用改良式髋关节支具压迫止血,穿刺部位未发生血肿、假性动脉瘤、渗血等并发症,肢体可适宜活动,患者舒适度提高。结论改良髋关节支具的应用,可增加肢体活动范围,避免长时间制动身体所致的僵直不适;穿刺部位压迫止血效果较好,均未发生相关并发症。     

木质圆柱止血棒用于股动脉拔鞘后止血的效果观察

目的改良股动脉鞘管穿刺点的压迫方法,解决冠状动脉造影及冠状动脉介入治疗(PCI)术后拔鞘止血耗时长、费力等,并减轻患者不适感。方法将80例患者随机分为对照组和改良组各40例。对照组采用传统指压后盐袋加压止血法,改良组采用自制木质圆柱止血棒加压止血。结果改良组压迫止血时间、患者紧张感和主观不适发生率显著短于/低于对照组(均P0.01);两组出血发生率比较,差异无统计学意义(P0.05)。结论冠状动脉造影及PCI术后拔鞘采用自制木质圆柱止血棒压迫止血安全有效,可减轻患者的痛苦,提高工作效率。     

血液透析患者股静脉、股动脉穿刺拔针后止血方法的探讨

目的减少局部并发症的发生。方法回顾总结80例894例次股静脉、股动脉穿刺止血效果。结果压球按压15min后绷带加压包扎法明显优于按压15min后沙袋压迫止血法,能有效地减少出血、血肿(P<0.01)。结论压球按压15min后绷带加压包扎法,减少了患者的痛苦,是一种理想的压迫止血法。     

介入术后鱼形沙袋压迫止血的效果观察

目的探讨介入术后压迫止血的有效方法,控制局部并发症发生.方法将行介入治疗的患者452例随机分为对照组(196例)和观察组(256例),对照组介入术后用高弹性胶布压迫止血,观察组用自制鱼形沙袋压迫止血.观察两组止血效果及并发症发生率.结果观察组无局部出血及并发症发生;对照组局部发生出血16例(8.16%),皮肤过敏反应128例(65.31%)、水泡50例(25.51%).两组比较,差异有显著性意义(均P＜0.01).结论介入术后患者采用自制鱼形沙袋压迫止血,止血效果显著,且能有效控制局部并发症的发生.     

经皮股动脉穿刺点采用血管封堵器止血患者的护理

目的探讨血管封堵器对血管性介入术后股动脉穿刺点止血的护理方法。方法55例患者行血管介入诊断治疗术后，股动脉穿刺点采用Angioseal封堵器止血，分析止血效果，观察有无植入部位出血和血肿、动脉血栓形成或栓塞及股动脉损伤等血管性并发症。结果血管封堵器止血成功率为98．2％，止血时间为（3．60±0．55）min，下床活动时间为（4．20±0．45）h；未发生严重并发症；股动脉穿刺点彩色多普勒超声随访未发现血管病变。结论血管封堵器对股动脉穿刺点能快速、有效地止血，患者能提前下床活动，及时、科学的护理可减少不良反应。     

不同止血方法对冠状动脉介入术后病人的影响

目的探讨血管缝合器对冠心病介入诊疗术后病人的影响。方法将 4 18例冠状动脉造影和介入治疗病人分为两组 ,观察组 2 0 8例术后应用血管缝合器止血 ,对照组 2 10例术后采用常规人工压迫止血 ,比较两组术后不良反应发生率。结果两组穿刺局部损伤、排尿困难、舒适度、失眠及焦虑发生率比较 ,差异有显著性意义 (均P <0 .0 1)。结论血管缝合器由于缩短了止血时间及卧床制动时间 ,不仅能减少穿刺局部的出血和血肿 ,尚能改善病人的焦虑心理、舒适度及睡眠 ,减轻排尿困难等不适。     

经皮股动脉穿刺点采用血管封堵器止血患者的护理

目的 探讨血管封堵器对血管性介入术后股动脉穿刺点止血的护理方法.方法 55例患者行血管介入诊断治疗术后,股动脉穿刺点采用Angioseal封堵器止血,分析止血效果,观察有无植入部位出血和血肿、动脉血栓形成或栓塞及股动脉损伤等血管性并发症.结果 血管封堵器止血成功率为98.2%,止血时间为(3.60±0.55)min,下床活动时间为(4.20±0.45)h;未发生严重并发症;股动脉穿刺点彩色多普勒超声随访未发现血管病变.结论 血管封堵器对股动脉穿刺点能快速、有效地止血,患者能提前下床活动,及时、科学的护理可减少不良反应.     

舒适型股动脉压迫带的设计与应用

行冠状动脉介入诊疗术(PCI)时,大多数患者需经股动脉穿刺,对穿刺点多采用弹性绷带缠绕固定,沙袋压迫.由于穿刺侧肢体长时间不能弯曲,处于制动体位,易引起腰背酸痛;同时老年人皮肤松弛,加压包扎的弹性绷带不易固定,导致血管穿刺并发症(PVC)的发生.     

冠状动脉介入术后桡动脉压迫方法的改进

目的 探讨冠状动脉介入术后桡动脉不同压迫止血方法的临床效果.方法 将100例经桡动脉穿刺冠状动脉介入检查治疗的患者随机分成观察组和对照组各50例,对照组采用弹力绷带加压包扎法.观察组采用宽胶带压迫止血法,比较两组止血效果.结果 两组各有2例患者发生局部出血;观察组SpO<,2>值,患侧手指发绀、肿胀发生率显著低于对照组,而舒适度显著高于对照组(均P<0.01).结论 经桡动脉行冠状动脉介入术后采用宽胶带压迫穿刺处止血法效果好,并发症少,舒适度高.     

The Influence of the Deep Femoral Artery on Wound Healing in Amputees

Seventeen patients with arterial occlusive disease, of whom 14 were diabetics, were studied by angiography after amputation of the lower extremity. In one patient the angiography was normal and the stump wound healed well. In two patients the angiographic findings indicated extremely severe impairment of blood supply and wound healing was considerably delayed. Of the remaining 14 patients: in five the superficial femoral artery alone was occluded and wound healing was normal and in nine patients, both the superficial and deep femoral arteries were occluded and wound healing was delayed.

Wound healing of the stump after amputation of the lower extremity due to extensive arterial occlusive disease is decided by the patency of the deep femoral artery.     

The Influence of the Deep Femoral Artery on Wound Healing in Amputees

Seventeen patients with arterial occlusive disease, of whom 14 were diabetics, were studied by angiography after amputation of the lower extremity. In one patient the angiography was normal and the stump wound healed well. In two patients the angiographic findings indicated extremely severe impairment of blood supply and wound healing was considerably delayed. Of the remaining 14 patients: in five the superficial femoral artery alone was occluded and wound healing was normal and in nine patients, both the superficial and deep femoral arteries were occluded and wound healing was delayed.

Wound healing of the stump after amputation of the lower extremity due to extensive arterial occlusive disease is decided by the patency of the deep femoral artery.     

Current Therapeutic Options in the Management of Superficial Femoral Artery Occlusive Disease

The management of superficial femoral artery occlusive disease remains challenging for vascular surgeons. Despite the advances and dramatic changes we have seen in modern practice with the development and introduction of new endovascular techniques, long-term results with these interventions remain disappointing when compared to the “gold standard” of a vein bypass with a good run-off. Furthermore, there is little Level 1 evidence to guide us with regards to the best treatment strategy. In this article, we review some of the currently available open surgical and endovascular options for the management of superficial femoral artery disease.     

集体心理干预在烧伤患者中的应用

目的 探讨介入术后压迫止血的有效方法。控制局部并发症发生。方法 将行介入治疗的患者452例随机分为对照组（196例）和观察组（256例），对照组介入术后用高弹性胶布压迫止血，观察组用自制鱼形沙袋压迫止血。观察两组止血效果压并发症发生率。结果 观察组无局部出血及并发症发生；对照组局部发生出血16例（8．16％）．皮肤过敏反应128例（65．31％）、水泡50例（25．51％）。两组比较，差异有显著性意义（均P〈0．01）。结论 介入术后患者采用自制鱼彤沙袋压迫止血．止血效果显著，且能有效控制局部并发症的发生。     

Ultrasonic Endarterectomy for Long Superficial Femoral Artery Atherosclerotic Occlusive Disease

OBJECTIVE: To report the long term results of ultrasonic superficial femoral artery endarterectomy (USFAE). DESIGN: Retrospective study. PATIENTS AND METHODS: From January 1998 to June 2004 218 USFAE were performed in 202 selected patients (178 males, 192 procedures) with a median age of 65 years (46-87 years). Indications for operation were disabling intermittent claudication in 137 procedures (68%), rest pain in 24 procedures (12%), and limb salvage in 41 procedures (20%). The new medical technology of ultrasonic endarterectomy is based on the application of the mechanical vibrations in the range of low frequency ultrasound. The ultrasonic device consists of the ultrasonic generator, acoustic unit and the flexible wave concentrators with special working tips in the shape of a ring. Follow up consisted of clinical evaluation, ankle-brachial index measurements and duplex scanning. RESULTS: The mean follow-up time was 30.1 months. The mean length of the endarterectomised SFAs was 29 cm (range, 15-43 cm). The five year cumulative primary patency rate by means of life table analysis was 45.8 +/- 4.4% (SE). Percutaneous transluminal balloon angioplasty and surgical re-interventions were performed in thirty three and five patients respectively resulting in a primary assisted patency rate of 57.5 +/- 4.1%. The five year secondary patency rate was 65.6 +/- 3.8%. Limb salvage was achieved in 35 of the 41 patients with gangrene. CONCLUSIONS: The long term results of ultrasonic SFA endarterectomy suggest this is an effective technique.