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止血贴用于老年冠状动脉慢性完全闭塞患者经股动脉7F动脉鞘管接受冠脉介入治疗的临床观察研究

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摘要:

目的 评估经皮止血贴在经股动脉接受介入治疗的老年冠状动脉慢性完全闭塞性病变患
者介入术后止血效果及早期下床活动的可靠性。方法 连续入选2016年1月~2018年4月就诊于辽宁省人
民医院心内科,明确诊断为CTO病变接受冠脉介入治疗的老年患者(>65岁)133例,随机分为观察
组(止血贴CLO-Sur PAD,72例)与对照组(按压止血,61例)。观察患者术后即刻止血时间、卧床
时间、术区相关出血情况、全身不良反应等。结果 使用止血贴的观察组患者的平均止血时间[(9.8±
1.9)min vs.(15.4±2.6)min]、加压包扎平均时间[(2.4±0.5)h vs.(8.6±3.1)h]和平均卧床时间[(4.1
±1.2)h vs.(20.4±4.3)h]均低于对照组患者(P均<0.001)。术区出血相关并发症的比较中,观察
组发生瘀斑(8.3% vs. 26.2%)、渗出(2.8% vs. 16.4%)和小血肿(2.8% vs. 13.1)的患者均少于对照组
(P均<0.05)。观察组出现迷走反射、尿潴留、后背酸痛、下肢麻木的人数均显著低于对照组(P均
<0.05)。结论 经股动脉接受介入治疗老年冠状动脉慢性完全闭塞性病变患者应用经皮无创止血贴止
血,能有效减少股动脉穿刺点术区出血相关并发症,缩短按压止血时间,提早下床活动,进而减轻全身
不良反应。

Abstract:

Objective To review the hemostatic effect of Hemostasis Pad (CLO-Sur PAD) and reliability of
early ambulation in elderly patients with chronic total occlusion of coronary artery (CTO) undergone transfemoral
interventional therapy. Methods CTO patients (aged>65, n=133) undergone coronary interventional therapy
were continuously chosen from Department of Cardiology in People’s Hospital of Liaoning Province from Jan.
2016 to Apr. 2018, and divided randomly into observation group (treated with CLO-Sur PAD, n=72) and control
group (treated with pressing to stop bleeding, n=61). The immediate hemostatic time, bed rest time, bleeding
complications related to the interventional procedure and systemic adverse reactions were observed after the
procedure. Results The average hemostatic time [(9.8±1.9) min vs. (15.4±2.6) min], average time of pressing to
stop bleeding [(2.4±0.5) h vs. (8.6±3.1) h] and average bed rest time [(4.1±1.2) h vs. (20.4±4.3) h] were all lower
in observation group than those in control group (all P<0.001). The comparison in bleeding complications related
to the interventional procedure showed that the patients with skin ecchymosis (8.3% vs. 26.2%), exudation (2.8% vs.
16.4%) and small subcutaneous hematoma (2.8% vs. 13.1) were all less in observation group than those in control
group (all P<0.05). The patients with vagus reflex, urinary retention, backache and numbness of lower limbs were
significantly less in observation group than those in control group (all P<0.05). Conclusion CLO-Sur PAD can
effectively reduce the bleeding complications related to the interventional procedure, shorten the time of pressing
to stop bleeding, advance early ambulation and decrease systemic adverse reactions in elderly patients with CTO
undergone transfemoral interventional therapy.

基金项目:

1 2014年辽宁省省直医院改革重点临床科室诊疗能力建设项目(LNCCC-B02-2014)

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