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目的探讨接受抗血小板治疗的老年患者在行外周血管介入操作后使用血管缝合器(Perclose)进行穿刺点止血的安全性。方法根据股动脉穿刺点止血方法,纳入2013-01—2014-06江苏省人民医院血管外科行外周血管介入治疗患者122例,年龄≥65岁,分为传统手工压迫组(manual compression,MC)和血管闭合器组(vascular closure device,VCD),2组患者术前均接受抗血小板治疗。出院前记录2组患者股动脉穿刺点止血时间和穿刺点并发症的发生率。结果 VCD组技术成功率为94.8%,止血时间为(3.5±0.3)min。MC组技术成功率为100%,止血时间为(17.0±0.7)min。在局部血肿、股动脉假性动脉瘤、下肢深静脉血栓形成及迷走神经反射等并发症的发生率方面,2组数据无统计学差异(P>0.05)。但是VCD组穿刺点渗血的发生率明显高于MC组(P<0.004)。2组总穿刺点并发症的发生率之间无差异(P=0.857)。结论对接受抗血小板治疗的老年患者,在外周血管介入治疗后采用MC法或者VCD法行穿刺点止血,均安全有效。
Objective To investigate the safety of using Perclose for puncture point in elderly patients receiving antiplatelet therapy after percutaneous vascular intervention. Methods According to the method of hemostasis of femoral artery puncture point, 122 patients (> 65 years old) with peripheral vascular interventional treatment who underwent vascular surgery in Jiangsu Provincial People’s Hospital from January 2013 to June 2014 were divided into two groups: manual compression (MC) Vascular closure device (VCD), two groups of patients received antiplatelet therapy before surgery. Pre-discharge records of two groups of patients femoral artery puncture site bleeding time and the incidence of complications. Results The technical success rate of VCD group was 94.8% and the bleeding time was (3.5 ± 0.3) min. The technical success rate of MC group was 100% and the bleeding time was (17.0 ± 0.7) min. In the local hematoma, femoral artery pseudoaneurysm, deep venous thrombosis and vagal reflex complications such as incidence, the two groups of data was not statistically significant (P> 0.05). However, the incidence of puncture point in VCD group was significantly higher than that in MC group (P <0.004). There was no difference between the two groups (P = 0.857) in the incidence of total puncture complications. Conclusion For elderly patients receiving antiplatelet therapy, it is safe and effective to use MC method or VCD method to stop bleeding after percutaneous vascular intervention.