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目的 :评价经皮冠状动脉介入治疗术 (PCI)后股动脉穿刺部位应用Perclose血管缝合器止血的安全性和有效性。方法 :对 2 5 6例PCI患者进行前瞻性研究 ,所有患者均接受阿司匹林、氯吡格雷以及肝素治疗 ,动脉鞘管均为F7,一组在完成PCI后立即拔除股动脉鞘管 ,选用Perclose血管缝合器对穿刺部位动脉进行止血 ,另一组为术后 4～ 6h测活化凝血时间 <180s后拔除鞘管采用手法压迫止血。结果 :Perclose血管缝合器止血的成功率为 95 % ,两组患者的主要并发症差异无统计学意义 ,但Perclose组并发症发生率有更低的趋势 (2 3.3%∶31.6 % )。Perclose组的止血时间 (5 .1± 3.4 )min ,手法压迫组 (2 8± 10 )min ;Perclose组制动时间 (6 .4± 1.7)h ,手法压迫组 (19± 6 .5 )h。二者Perclose组均明显较手法压迫组缩短。结论 :Perclose血管缝合器是一个迅速、有效的止血方法 ,值得临床上推广。
Objective: To evaluate the safety and efficacy of Perclose vascular stapler in the femoral artery puncture after percutaneous coronary intervention (PCI). METHODS: Twenty-five PCI patients were prospectively studied. All patients received aspirin, clopidogrel, and heparin. The arterial sheaths were all F7. One group received femoral arterial sheath withdrawal immediately after PCI. Perclose blood vessels Stitches on the puncture site arteries to stop bleeding, and the other group 4 ~ 6h postoperative activation coagulation time <180s after the removal of the sheath using the method of oppression to stop bleeding. Results: The success rate of Perclose vascular stapler was 95%. No significant difference was found between the two groups. However, the incidence of complications in Perclose group was lower (3.3%: 31.6%). The bleeding time in Perclose group was (5.1 ± 3.4) min, in manual compression group (28 ± 10) min, in Perclose group (6.4 ± 1.7) h, in manual compression group (19 ± 6.5) h . Both Perclose group were significantly shorter than the manual compression group. Conclusion: Perclose vascular stapler is a rapid and effective method of hemostasis, worthy of clinical promotion.