摘要
目的探讨不同穿刺点止血方案对于脑血管内支架植入术后血管并发症的作用。方法收集2019年1月至2020年10月在海军军医大学第二附属医院接受经皮血管内支架成形术(PTAS)治疗的缺血性脑血管病(ICVD)患者的临床资料,并根据压迫方式不同分为常规组(采用常规压迫止血方案)和观察组(采用短时指压止血方案),各39例。比较两组患者的压迫止血效果、血管并发症及相关并发症发生情况,比较两组患者术后恢复指标(制动时间、下床活动时间、住院时间),以及手术前后血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)]。结果观察组患者的血管并发症发生率为10.26%(4/39),低于常规组患者的28.21%(11/39),差异有统计学意义(P<0.05)。全部并发症均给予对症处理,经再压迫或切开、缝合后均消失。观察组患者相关并发症的总发生率为5.13%(2/39),低于常规组患者的33.33%(13/39),差异有统计学意义(P<0.05)。全部不良反应经按摩、适度活动等干预后均消失。术后3 d,观察组患者的VEGF、ET-1水平均低于常规组患者,差异有统计学意义(P<0.05)。术后3 d,观察组患者的NO水平高于常规组患者,差异有统计学意义(P<0.05)。结论缩短压迫时间至15 min、术肢制动6 h的压迫止血方案能够降低ICVD患者术后血管并发症的发生风险,促进患者术后血管内皮功能更好的恢复。
Objective To investigate the effect of different puncture point hemostasis scheme on vascular complications after cerebral vascular stent implantation in patients with ischemic cerebrovascular disease.Method The clinical data of patients with ischemic cerebrovascular disease(ICVD)who received percutaneous transluminal angioplasty stent(PTAS)in Second Affiliated Hospital of Naval Medical University from January 2019 to October 2020 were collected.According to different compression methods,they were divided into conventional group(using conventional compression hemostasis scheme)and study group(using short-term finger compression hemostasis scheme),39 cases in each group.The effect of compression hemostasis,vascular complications and the incidence of related complications were compared between the two groups.The postoperative recovery indicators of the two groups were compared,including braking time,time of getting out of bed and length of hospital stay.The indexes of vascular endothelial function of all patients before and after surgery were compared,including endothelin-1(ET-1),nitric oxide(NO)and vascular endothelial growth factor(VEGF)levels.Result The incidence of vascular complications in the study group was 10.26%(4/39),which was lower than 28.21%(11/39)in the conventional group(P<0.05).All complications were treated with symptomatic treatment,and disappeared after re compression,incision and suture.The total incidence of related complications in the study group was 5.13%(2/39),which was lower than 33.33%(13/39)in the conventional group(P<0.05).All the adverse reactions disappeared after massage and moderate exercise.Three days after operation,the levels of VEGF and ET-1 in the study group were lower than those in the conventional group,and the difference was statistically significant(P<0.05).Three days after operation,the level of NO in the study group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion The compression hemostasis scheme of short
作者
周晓闻
庄建华
刘洪超
Zhou Xiaowen;Zhuang Jianhua;Liu Hongchao(Department of Neurology,Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Department of Intervention,Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China)
出处
《血管与腔内血管外科杂志》
2021年第2期183-187,共5页
Journal of Vascular and Endovascular Surgery
基金
上海市科学技术委员会科研计划项目(18ZR1439200)
关键词
压迫止血
压迫时间
经皮血管内支架成形术
缺血性脑血管病
血管并发症
compression hemostasis
compression time
percutaneous transluminal angioplasty stent
ischemic cerebrovascular disease
vascular complication
