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目的评价老年冠状动脉(简称冠脉)介入诊疗术后Perclose血管缝合止血的安全性和临床效果。方法204例老年冠脉介入诊疗术后患者,97例应用Perclose缝合器止血(称缝合组),107例应用手工压迫止血方法止血(称对照组)。分别记录止血时间、下肢制动时间和手术相关并发症。结果缝合组:缝合成功率92.8%;止血时间1.9±1.2min;下肢制动时间4.0±0.9h;并发症发生率为3.1%。对照组:一次止血成功率93.5%;止血时间27.5±10.5min;下肢制动时间22.0±4.3h;手术相关并发症发生率为18.7%。统计学处理显示:缝合组与对照组的止血成功率无显著性差异(χ2=1.16,P>0.05);缝合组的止血时间和下肢制动时间明显较对照组缩短(t止血=17.3熏t制动=29.3熏P<0.01);对照组手术相关并发症发生率明显高于缝合组(χ2=8.7熏P<0.01)。结论用Perclose血管缝合器处理老年冠脉介入诊疗术后穿刺血管安全有效,与手工压迫止血比有以下优点:①止血时间和下肢制动时间明显缩短,减少了因制动给患者带来的不适;②明显减少手术相关并发症的发生。缺点:Perclose血管缝合的直接费用较高。
Objective To evaluate the safety and clinical efficacy of Perclose suture in the treatment of senile coronary artery (referred to as coronary artery) after interventional therapy. Methods Totally 204 elderly patients undergoing coronary intervention were treated by percutaneous occlusion (97 cases). The patients were treated with Perclose suture to stop bleeding (called suture group) and 107 cases were treated with manual hemostasis (control group). Respectively record the bleeding time, lower limb brake time and surgery-related complications. Results In the suture group, the successful rate of suture was 92.8%, the bleeding time was 1.9 ± 1.2 minutes, the lower limb brake time was 4.0 ± 0.9 hours and the complication rate was 3.1%. Control group: a hemostatic success rate of 93.5%; hemostasis time of 27.5 ± 10.5min; lower limb brake time 22.0 ± 4.3h; surgery-related complications was 18.7%. Statistical analysis showed that there was no significant difference in the success rate of hemostasis between the suture group and the control group (χ2 = 1.16, P> 0.05); the hemostatic time and the lower limb immobilization time in the suture group were significantly shorter than those in the control group (t = Brake = 29.3 smoked P <0.01). The incidence of surgery-related complications in the control group was significantly higher than that in the suture group (χ2 = 8.7 smoked P <0.01). Conclusion Perclose vascular stapler is safe and effective in the treatment of elderly patients after percutaneous coronary intervention. Compared with manual compression, hemostasis has the following advantages: (1) Hemostasis time and lower limb braking time are significantly shortened, which reduces the discomfort caused by braking ; ② significantly reduce the incidence of surgery-related complications. Disadvantages: Perclose vascular suture direct higher cost.