改良桡动脉止血器在老年ACS患者动脉穿刺后压迫止血中的效果

目的 评价改良后桡动脉止血器用于老年急性冠脉综合征（ACS）患者桡动脉及肱动脉穿刺后压迫止血的效果。方法 选取某三级综合医院2016年1月~12月收治的109例老年ACS三联抗凝的患者作为对照组，另选取该院2017年1~12月收治的123例老年ACS三联抗凝的患者设为实验组，对照组动脉穿刺后常规压迫止血。实验组动脉穿刺后常规压迫止血后使用改良后桡动脉止血器继续压迫止血30 min。评价两组穿刺后12、24、36、48 h穿刺点有无皮下淤血（皮下淤血直径≥2 cm）、血肿等情况。结果 两组桡动脉和肱动脉皮下瘀斑及血肿发生率比较，差异有统计学意义（P＜0.05）；实验组发生皮下淤斑主要在穿刺12 h内，各时间段均没有血肿发生；对照组皮下瘀斑主要发生在穿刺12~24 h，血肿在穿刺12、24、36、48 h内均有发生。结论改良后桡动脉止血器能有效降低老年急性冠脉综合征三联抗凝治疗后桡动脉及肱动脉穿刺后皮下淤血、血肿的发生。

Evaluation of Improved Radial Arterial Hemostatic Device in Compression Hemostasis After Arterial Puncture in Elderly Patients with ACS

Objective To evaluate the effect of modified radial hemostatic device on hemostasis after compression of radial and brachial artery in elderly patients with acute coronary syndrome （ACS）. Methods A total of 96 elderly patients with ACS triple anticoagulation treated in a tertiary general hospital from January to December 2016 were selected as the control group. Another 102 elderly patients with ACS triple anticoagulation treated in this hospital from January to December 2017 were selected. The patients were set as the experimental group, and the control group was routinely compressed to stop bleeding after arterial puncture. The experimental group was subjected to conventional compression hemostasis after arterial puncture, and the modified radial artery hemostatic device was used to continue the compression hemostasis for 30 min. The presence of subcutaneous congestion （subcutaneous congestion diameter≥2 cm） and hematoma at the puncture sites at 12,24,36 and 48 h after puncture were evaluated in both groups.Results There was a statistically significant difference in the incidence of subcutaneous ecchymosis and hematoma of the radial and brachial arteries between the two groups （P<0.05）. Subcutaneous ecchymosis occurred in the experimental group mainly within 12 hours of puncture, and no hematoma occurred in each period; Subcutaneous ecchymosis mainly occurred at 12-24 h of puncture, and hematoma occurred at 12,24,36,48 h of puncture.Conclusion The improved radial artery hemostatic device can effectively reduce the occurrence of subcutaneous congestion and hematoma after radial artery and brachial artery puncture after triple anticoagulation in elderly patients with acute coronary syndrome.