摘要
目的 评价在肝素联合强效抗血小板制剂GPⅡb Ⅲa受体拮抗剂应用的情况下 ,经皮穿刺冠状动脉介入治疗 (PCI)术后使用Angio SealTM的效果和患者的满意度。方法 本组 16 1例患者接受肝素、GPⅡb Ⅲa受体拮抗剂和常规PCI治疗 ,其中术后应用Angio SealTM(A组 ) 10 5例 ,Femostop(B组 ) 5 6例。观察两组术后止血时间、早期行走时间和血管并发症及电话随访出院后 4 8h患者的满意度 ,并进行统计学分析。结果 Angio SealTM应用成功率为 98.1%。两组术后止血时间分别是 (1.8± 2 .2 )min和 (12 9± 5 1)min (P <0 .0 0 0 1) ;术后早期开始行走时间分别为(6 .4± 2 .3)h和 (15 .2± 4 .8)h(P <0 .0 0 0 1)。A组出现 2例血肿 ,均保守治疗 ;B组分别有 3例血肿 ,2例假性动脉瘤和 1例动静脉瘘 ,其中 3例送外科手术 ;两组总血管并发症的发生率分别为 1.9%与 10 .7% (P <0 .0 5 )。术后住院时间分别为 (2 8.2± 10 .4 )h和 (5 8.4± 10 .2 )h(P <0 .0 0 0 1)。出院后 4 8h随访满意度两组分别为 93.3%和 6 0 .7% (P<0 .0 0 1)。结论 在需要强效抗凝的情况下 ,PCI术后应用Angio SealTM在即刻止血、早期行走和缩短住院时间方面均优于传统压迫方法 ,尤其是能显著降低血管并发症的发生率和提高患者的满意度。
Objective To evaluate the effect and patient satisfaction of Angio-Seal TM after PCI in patients receiving heparin and glycoprotein Ⅱb-Ⅲa inhibitors.Methods All 161 patients received heparin and GP Ⅱb-Ⅲa inhibitors and conventional PCI procedures were included.Angio-Seal TM were deployed in 105 patients (group A) and Femostops were deployed in 56 patients (group B).The time to hemostasis and the time to ambulation and vascular complications were observed.Patients were followed up by telephone 48h after discharge and patient satisfaction was evaluated.All data was statistically analysed.Results The success rate of Angio-Seal TM was 98.1%.The time to hemostasis of two groups was (1.8±2.2)min vs.(129±51)min (P<0.0001), time to early ambulation was (6.4±2.3)h vs.(15.2±4.8)h (P<0.0001) respectively.2 hematomas occurred in group A were treated by compression. In group B 3 had hematoma,2 had pseudoaneurysm and 1 had a A-V fistula,3 of them were sent for surgery.Overall vascular complications in two groups was 1.9% and 10.7% respectively (P<0.05). The postprocedure hospital stay was (28.2±10.4)h and (58.4±10.2)h respectively (P<0.0001), patient satisfaction of 48h,follow-up after discharge was 93.3% and 60.7% repectively (P<0.001).Conclusions In appropriately selected patients who need strong anticoangulation,the use of vascular closure device Angio-Seal TM is better than traditional compression in instant hemostasis,early ambulation and discharge,especially it can significantly reduce vascular complications and improve patient satisfaction.
出处
《北京医学》
CAS
北大核心
2004年第6期373-375,共3页
Beijing Medical Journal
