手工压迫、血管压迫器和血管缝合器三种止血方式用于脑血管介入的随机对照研究

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摘要 [摘要]目的探析手工压迫、血管压迫器和血管缝合器三种止血方式用于脑血管介入的临床效果。方法选取2017年3月～2018年4月我科收治的102例经股动脉行介入治疗的患者作为研究对象，按照病历号将其随机分成手工压迫组（40例，手工压迫止血）、血管压迫器组（40例，血管压迫器止血）与血管缝合器组（22例，血管缝合器止血）。术前与术后1 d及3个月检测穿刺部位及附近3 cm内股动脉最小内径、收缩期血流峰速度，观察三组患者是否出现血栓、动静脉瘘及假性动脉瘤等，并比较三组患者的并发症（血肿、血压下降、心率减慢）发生情况。结果三组患者术前的股动脉最小内径、收缩期血流峰速度比较，差异无统计学意义（P>0.05）；血管缝合器组患者术后1 d及3个月的股动脉最小内径均显著小于手工压迫组和血管压迫器组，收缩期血流峰速度均显著低于手工压迫组和血管压迫器组，差异有统计学意义（P<0.05）。三组患者均未出现血栓、动静瘘及假性动脉瘤。血管缝合器组患者的并发症总发生率显著低于手工压迫组和血管压迫器组，差异有统计学意义（P<0.05）；血管压迫器组患者的并发症总发生率低于手工压迫组，差异有统计学意义（P<0.05）。结论脑血管行股动脉穿刺术后予以血管缝合器止血方式能够降低术后并发症发生率，患者的舒适度更高，起效迅速，值得临床推广。

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关键词 ：脑血管介入术, 血管缝合器, 血管压迫器, 手工压迫

Abstract：[Abstract]Objective To investigate the clinical effect of three kinds of hemostasis Methods of manual compression,vascular compression device and vascular suturing device in the application of cerebrovascular intervention.Methods A total of 102 patients who underwent the transfemoral intervention therapy from March 2017 to April 2018 in our department were selected as research subjects.According to the medical record number,they were randomly divided into the manual compression group(40 cases,manual compression hemostasis),the vascular compression device group(40 cases,vascular compression device hemostasis)and the vascular suturing device group (22 cases,vascular suturing device hemostasis).The minimum internal diameter of the femoral artery and the peak velocity of the systolic blood flow before operation and 1 day and 3 months after operation were measured at the puncture site and around 3 cm of femoral artery among the three gruops.The thrombosis,arteriovenous fistula and pseudoaneurysm were observed and complications(hematoma,decreasing blood pressure and heart rate)were compared among the three gruops.Results There were no significant differences in the minimum internal diameter of the femoral artery and the peak velocity of the systolic blood flow among the three groups before operation(P>0.05).The minimum internal diameter of the femoral artery at 1 day and 3 months after operation in the vascular suturing device group was significantly smaller than that in the manual compression group and the vascular compression device group,the peak velocity of the systolic blood flow at 1 day and 3 months after operation in the vascular suturing device group was significantly lower than that in the manual compression group and the vascular compression device group,and the differences were statistically significant(P<0.05).No thrombosis,arteriovenous fistula and pseudoaneurysm occurred among the three gruops.The total incidence rate of com-plications in the vascular suturing group was significantly lower than that in the manual compression group and the vascular compression device group,and the difference was statistically significant(P<0.05).The total incidence rate of complications in the vascular compression device group was significantly lower than that in the manual compression group,and the difference was statistically significant(P<0.05).Conclusion The hemostasis of vascular sutures after cerebral vascular femoral artery puncture can reduce the incidence rate of postoperative complications,the patients′comfort is higher,and the onset is rapid,which is worthy of clinical promotion.

Key words： Cerebrovascularintervention Vascularsuturing device Vascularcompression device Manual compression

基金资助:广东省中山市医学科研项目（2017A020322）

引用本文:

黄文勇；秦徳广；杨灵；陈检根；黄志鹏. 手工压迫、血管压迫器和血管缝合器三种止血方式用于脑血管介入的随机对照研究[J]. 中国当代医药, 2019, 26(7): 84-87.
HUANG Wen-yongQIN De-guangYANG LingCHEN Jian-gen HUANG Zhi-peng. Randomized controlled study of three kinds of hemostasis Methods of manual compression,vascular compression device and vascular suturing device in the application of cerebrovascular intervention. 中国当代医药, 2019, 26(7): 84-87.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2019/V26/I7/84

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