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目的:探讨结构性心脏病患者股动脉穿刺后采用壳聚糖止血敷料协助压迫止血的效果及其相关因素。方法:将需要行股动脉穿刺实施介入操作的结构性心脏病患者随机分成试验组和对照组2组,每组100例,心导管术时均使用6F或7F动脉鞘。术后分别采用壳聚糖止血敷料加压迫止血和传统压迫止血方式进行止血,记录压迫止血时间。试验组加压包扎4 h后患者活动下肢,对照组加压包扎6 h,平卧24 h,然后下床活动,记录出血并发症。结果:试验组和对照组压迫止血时间分别为(4.0±1.5)min和(7.6±2.5)min(P<0.05),总体出血并发症分别为3%和11%(P<0.05)。试验组仅有3例出现渗血,而对照组分别出现3例渗血,4例出血和4例血肿。多元回归分析显示,在对照组中,年龄、体质量指数、血压、血小板计数和凝血酶原时间国际标准化比值对压迫止血时间无明显影响,而试验组压迫时间与血压水平呈正相关。结论:壳聚糖止血敷料可有效缩短股动脉穿刺后压迫时间,并减少出血并发症。
Objective: To investigate the effect of chitosan hemostatic dressing on compression hemostasis after femoral artery puncture in patients with structural heart disease and its related factors. Methods: Patients with structural heart disease requiring interventional femoral artery puncture were randomly divided into two groups (experimental group and control group): 100 cases in each group and 6F or 7F arterial sheath in cardiac catheterization. Postoperative use of chitosan hemostatic dressing plus compression hemostasis and traditional hemostasis to stop bleeding, record compression hemostasis time. In the experimental group, the lower extremities of the patients under pressure banding for 4 hours followed by pressure dressing in the control group for 6 hours, supine for 24 hours, then getting out of bed and recording the bleeding complications. Results: The compression hemostasis time was (4.0 ± 1.5) min and (7.6 ± 2.5) min respectively in experimental group and control group (P <0.05). The overall bleeding complications were 3% and 11% respectively (P <0.05). Only 3 patients in the experimental group developed oozing, while 3 patients in the control group had oozing, 4 bleeding and 4 hematoma respectively. Multivariate regression analysis showed that in the control group, the age, body mass index, blood pressure, platelet count and prothrombin time international standardization ratio had no significant effect on the compression of bleeding time, while the test group compression time and the level of blood pressure was positively correlated. Conclusion: Chitosan hemostatic dressing can shorten the compression time after femoral artery puncture and reduce the bleeding complications.