旋压式桡动脉止血器改良加压包扎对冠状动脉介入术后止血效果和舒适度的影响

目的观察桡动脉止血器改良加压包扎对冠状动脉介入术后止血效果和舒适度的影响。方法将180例经皮穿刺桡动脉进行冠状动脉造影或介入治疗的病人随机分为纱布绷带加压组（A组）、旋压式止血器组（B组）和旋压式止血器改良加压包扎组（C组），观察3组的止血疗效和病人的舒适度。结果3组病人桡动脉穿刺一次成功率、接受经皮冠状动脉介入治疗术率差异均无统计学意义（P>0.05），术后出血率A组高于B组和C组（P < 0.01和P < 0.05）。术后腕围A组和B组均大于C组（P < 0.01）；血氧饱和度A组和C组均大于B组（P < 0.01）。术后淤青率、小肿块率、皮损率、桡动脉闭塞率差异均有统计学意义（P < 0.05~P < 0.01），大肿块率差异无统计学意义（P>0.05）；其中，淤青率A组高于B组和C组；小肿块率A组高于B组；皮损率A组低于C组，C组低于B组；桡动脉闭塞率A组低于B组（P < 0.05~P < 0.01）。结论桡动脉止血器改良加压包扎可以在有效止血的同时降低局部并发生的发生率，提高病人术后舒适度。

Effect of the pressure dressing of modified spinning radial artery hemostatic device on postoperative hemostasis and comfort of patients after coronary intervention

ObjectiveTo evaluate the effects of the pressure dressing of modified spinning radial artery hemostatic device on postoperative hemostasis and comfort after coronary intervention.MethodsOne hundred and eighty patients treated with coronary arteriography or interventional therapy through transdermal puncture of radial artery were randomly divided into the gauze bandage pressuring group(group A), spinning tourniquet group(group B) and modified spinning tourniquet pressuring group(group C).The efficacy of hemostasis and comfort in three groups were observed.ResultsThe differences of the one-time success rate of puncture of radial artery and percutaneous coronary intervention rate among three groups were not statistically significant(P>0.05).The postoperative bleeding rates in group A, group B and group C gradually decreased(P < 0.01 and P < 0.05).The postoperative wrist circumference in group A and group B were greater than that in group C(P < 0.01).The oxyhemoglobin saturation in group A and group C was greater than that in group B(P < 0.01), and the difference of which between group A and group C was not statistically significant(P>0.05).The differences of the postoperative bruising rate, small mass rate, skin lesion rate and radial artery occlusion rate among three groups were statistically significant(P < 0.05 to P < 0.01), and the differences of large mass rate among three groups were not statistically significant(P>0.05).The bruising rate in group A was higher than that in group B and group C.The small mass rate in group A was higher than that in group B.The skin lesion rates in group A and group C were lower than that in group C and group B, respectively.The radial artery occlusion rate in group A was lower than that in group B(P < 0.05 to P < 0.01).ConclusionsThe modified spinning tourniquet pressuring of radial artery can effectively stop bleeding, decrease complication, and improve the comfort of patients.