止血器压力对经桡动脉行冠状动脉介入诊治术后患者局部主要并发症的影响

目的 通过观察经桡动脉行冠状动脉介入诊治术后患者局部主要并发症（出血、肿胀）发生率,探讨止血器压力对术后局部主要并发症的影响.方法 选择2011年8-12月在中山大学附属第一医院心介入内科经桡动脉行冠状动脉介入诊治术后患者198例.通过询问、现场测量与观察、实验室检查相结合的方法,收集入选病例的围手术期用于判断局部主要并发症的各项指标.比较局部主要并发症发生组与未发生组患者的桡动脉止血器起始压力.结果 局部主要并发症发生组与未发生组加压总圈数比较（4.66/4.33）,差异无统计学意义（Z=0.157,P＞0.05）.两组患者的桡动脉止血器起始压力（1668.77 ±568.59）/（1613.13 ±557.09）mm Hg]比较,差异无统计学意义（t=0.693,P＞0.05）.手术结束时收缩压和止血器起始压力的相关系数（r）=-0.029（P=0.784）.结论 止血器加压总圈数不是判断经桡动脉行介入诊治术后穿刺点压力的最好指标.在一定范围内,止血器压力并非经桡动脉行冠状动脉介入诊治术后局部主要并发症的显著影响因素,手术结束时收缩压不是调节止血器起始压力的首选参考指标.

Effect of compressor pressure on local complications after trans-radial coronary intervention

Objective To observe the incidence rates of local complications （bleeding and swelling）after trans-radial coronary intervention （TRI） and to investigate the effect of compressor pressure on these adverse events.Methods A total of 198 cases of TRI performed at the Department of Interventional Cardiology of 1st Affiliated Hospital of Sun Yat-sen University from August 2011 to December 2011 were chosen in the present study.The indicators of judgment for the local complications were collected by means of direct inquiry,point-of-care observation and measurements and laboratory testing in peri-operation period.The initial pressure of radial compressor was compared between the patients who developed complications and patients who did not.SPSS 18.0 software was applied for all statistical analyses.Results Total circles applied for pressure was similar （4.66/4.3） between the group which developed local complications and the group which did not （Z =0.157,P ＞0.05）.The initial pressure applied by the radial compressor was similar （1668.77 ± 568.59）/（1613.13 ± 557.09） mm Hg] in two groups,and the difference was no statistically significant （t =0.693,P ＞0.05）.Correlation coefficient （r） between post-operative systolic pressure and initial pressure applied by the compressor was-0.029 （P =0.784）.Conclusions Total amount of circles tightened is not a good indicator of judgment for puncture site in TRI.Pressure transfer membrane is useful in measuring pressure applied at puncture site after TRI.Within certain range,compressor pressure is not a major impact factor on local complications after TRI.The systolic pressure at the ending of operation is not the first reference to regulate the initial pressure of radial compressor.