摘要
目的探讨壳聚糖止血海绵联合螺旋桡动脉压迫器在经桡动脉冠状动脉介入(TRI)术后的止血效果。方法选取2021年4月至2022年7月在江西省人民医院心血管内科四区经桡动脉途径行冠状动脉造影或冠状动脉粥样硬化性心脏病介入治疗的患者295例,采用随机数字表法分为螺旋桡动脉压迫器组(A组,99例)、壳聚糖止血海绵组(B组,98例)及壳聚糖止血海绵联合螺旋桡动脉压迫器组(C组,98例),3组采用对应方法止血。观察记录3组术后桡动脉血管并发症及患者舒适度情况。结果A组、B组及C组术后出血发生率分别为13.1%(13/99)、5.1%(5/98)、3.1%(3/98),术后出血、瘀斑、肢端肿胀发生率3组间差异均有统计学意义(均P<0.05),组间两两比较A组高于C组(均P<0.05)。术后桡骨血肿发生率A组高于C组(P=0.008)。所有患者均未发生术侧严重肢端肿胀及其他严重并发症。C组患者舒适度优于A组(P=0.004)。结论壳聚糖止血海绵联合螺旋桡动脉压迫器在TRI术后总体止血效果优于单独使用螺旋桡动脉压迫器和壳聚糖止血海绵,可减少术后血管并发症发生率,提高患者舒适度,是一种操作简单、舒适度高、并发症少、安全可靠的止血方法。
Objective To explore the hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor after transradial percutaneous coronary intervention(TRI).Methods From April 2021 to July 2022,295 patients who underwent coronary angiography or interventional therapy for coronary atherosclerotic heart disease in the fourth district of the Department of Cardiovascular Medicine,Jiangxi Provincial People′s Hospital were selected.The patients were randomly divided into spiral radial artery compressor group(group A,99 cases),chitosan hemostatic sponge group(group B,98 cases),and chitosan hemostatic sponge combined with spiral radial artery compressor group(group C,98 cases).The three groups were treated with corresponding methods to stop bleeding.The postoperative radial artery complications and patient comfort were observed and recorded in the three groups.Results The incidence rates of postoperative bleeding in group A,group B,and group C were 13.1%(13/99),5.1%(5/98),and 3.1%(3/98),respectively,and there were significant differences in the incidence of postoperative bleeding,ecchymosis and acral swelling among the three groups(all P<0.05).Group A was higher than group C in pairwise comparison(P<0.05).The incidence of postoperative radial hematoma in group A was higher than that in group C(P=0.008).No severe limb swelling and other serious complications occurred in all patients.The comfort level of patients in group C was better than that in group A(P=0.004).Conclusion The overall hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor is better than that of spiral radial artery compressor and chitosan hemostatic sponge alone after TRI.It can reduce the incidence of postoperative vascular complications and improve the comfort of patients.It is a simple operation,high comfort,less complications,safe and reliable method of dressing hemostasis.
作者
余龙辉
宋梦丽
陈丽燕
谭文亮
蔡露
熊红英
涂伟玲
李林锋
康信军
Yu Longhui;Song Mengli;Chen Liyan;Tan Wenliang;Cai Lu;Xiong Hongying;Tu Weiling;Li Linfeng;Kang Xinjun(Department of Cardiovascular Medicine,Jiangxi Provincial People′s Hospital,the First Affiliated Hospital of Nanchang Medical College,Nanchang 330000,China;Nanchang University Jiangxi Medical College,Nanchang 330000,China;Department of Cardiovascular Medicine,Wan′an County People′s Hospital of Ji′an City,Jiangxi Province,Ji′an 343800,China)
出处
《中国医药》
2024年第6期806-810,共5页
China Medicine
基金
江西省卫生健康委科技计划(202130091)。
关键词
壳聚糖止血海绵
桡动脉
冠状动脉介入治疗
血管并发症
Chitosan hemostatic sponge
Radial artery
Coronary intervention
Vascular complications
