壳聚糖止血敷料用于经股动脉穿刺先天性心脏病介入治疗压迫止血的临床观察

目的探讨壳聚糖止血敷料在经股动脉穿刺先天性心脏病介入治疗术后血管穿刺部位止血的临床应用效果。方法 2009年9月至2010年5月,选择先天性心脏病住院行室间隔缺损、动脉导管末闭介入治疗手术患者100例。按术后是否应用壳聚糖止血敷料分为2组,每组50例,年龄2～51岁。壳聚糖组应用壳聚糖止血敷料止血,对照组则采用传统人工压迫方法止血。比较两组止血操作及患者制动时间以及排尿、情绪、睡眠等情况。结果壳聚糖组止血成功率100%,对照组止血成功率为86%,两组比较差异有统计学意义(P<0.05)。壳聚糖组平均止血操作[(9.5±6.2)min]及制动时间[(10.2±4.6)h]明显少于对照组[(18.4±5.1)min,(24.7±5.8)h](均为P<0.001),同时,壳聚糖组出现腰背酸痛、排尿困难、烦躁、迷走神经反射及血肿的发生率也低于对照组,其中睡眠困难的发生率两者比较差异有统计学意义(P<0.001)。结论先天性心脏病介入治疗术后应用壳聚糖止血敷料止血效果好,明显缩短止血和患者制动时间,不增加局部血肿等并发症。

Use of chitosan dressings in patients with congenital heart disease underwent interventional therapy

Objective To evaluate the hemostatic effect of chitosan dressings in patients with congenital heart disease who underwent interventional therapy. Methods From September 2009 to May 2010, 100 patients with congenital heart disease, aged from 2 to 51 years old, were enrolled in this study and divided into chitosan dressings group （n =50） and control group （n = 50）. Time to hemostasis and the restrain time as well as intervention related complications of patients between the two groups were compared. Results The hemostasis and the restrain time of patients in chitosan dressings group were shorter than those in control group [ （9.5 ± 6.2 ） rain vs （ 18.4± 5. 1 ） min and （ 10.2 ±4.6 ） h vs （24.7± 5. 8） h, respectively, both P 〈 0. 001 ）. Complications such as back pain, urinary retention, psychentonia insomnia, hemmThage and hematoma were less common in chitosan dressings group than in control group. Conclusions The use of chitosan dressings in patients with congenital heart disease underwent interventional therapy can remarkably shorten hemostasis and restrain time and reduce the risk of intervention related complications.