2019 年第 7 期 第 14 卷

经桡动脉穿刺冠状动脉介入治疗后应用新型止血材料联合动脉压迫装置的止血效果研究

Hemostatic effect of new hemostatic material combined with arterial compression device on patients with transradial coronary intervention

作者：索旻聂绍平艾辉阙斌王春梅甄雷

英文作者：

单位：100029首都医科大学附属北京安贞医院急诊危重症中心北京市心肺血管疾病研究所

英文单位：

关键词：    冠状动脉介入；桡动脉压迫；壳聚糖

英文关键词：

• 摘要：

• 【摘要】目的    探讨壳聚糖护创止血材料与桡动脉压迫器装置联合使用在经桡动脉冠状动脉介入治疗穿刺部位止血的效果。方法    选取2017年2—7月首都医科大学附属北京安贞医院因胸痛就诊并收入院行冠状动脉造影的患者130例，均经右桡动脉穿刺成功。完全随机分为2组，观察组（60例，使用壳聚糖止血海绵联合旋钮式桡动脉压迫器）和对照组（70例，使用旋钮式桡动脉压迫器）。采集临床基础资料、手术相关指标并观察术后止血效果，记录压迫时间、术侧手掌肿胀程度、患者满意度等指标。结果    2组患者基线临床资料及主要实验室检查指标比较差异均无统计学意义（均P＞0.05）。2组患者术中肝素用量、术后活化凝血时间、经皮冠状动脉支架介入比例等手术相关指标比较，差异均无统计学意义（均P＞0.05）。观察组压迫时间明显短于对照组［（250±32）min比（379±39）min］（P＜0.001）。2组术侧手掌肿胀程度差异无统计学意义（P=0.359）。2组按计划解除包扎成功比例差异无统计学意义（P＝0.133）；观察组按计划解除包扎且穿刺部位患者满意的比例明显高于对照组［58.3%（35/60）比40.0%（28/70）］（P＝0.037）。结论    新型止血材料壳聚糖联合桡动脉压迫装置使用时止血效果可靠，可缩短压迫时间，患者满意度高，可以为临床工作提供一种较好的桡动脉介入治疗术后止血方法。

• 【Abstract】Objective    To investigate the hemostatic effect of chitosan, a new hemostatic material, combined with radial artery compression, on patients with coronary interventional therapy via transradial approach. Methods    A total of 130 patients undergoing coronary angiography with right radial artery access in Beijing Anzhen Hospital, Capital Medical University from February to July 2017 were randomly divided into experimental group(60 cases, using chitosan and arterial compression device) and control group(70 cases, using arterial compression device). Clinical data and operation records were analyzed. Hemostatic effect was evaluated by the duration of compression, right palm swelling and patient satisfaction. Results    Baseline data and main laboratory indices showed no significant difference between groups（P＞0.05）. Intraoperative heparin dosage, postoperative activated coagulation time and rate of stent implantation showed no significant difference between groups（P＞0.05）. Duration of compression in experimental group was significantly shorter than that in control group［（250±32）min vs （379±39）min］（P＜0.001）. Postoperative right plam swelling and compression successful release rate showed no significant difference between groups（P＝0.359, 0.133）. Patient satisfaction of hemostatic effect in experimental group was significantly higher than that in control group［58.3%（35/60） vs 40.0%（28/70）］（P＝0.037）. Conclusions    Chitosan combined with arterial compression shows a good hemostatic effect on patients with transradial coronary intervention. It can shorten compression time, improve patient satisfaction and provide a preferable hemostasis method for transradial procedure.