摘要
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 efficacy and safety of vascular closure device(Perclose) following peripheral artery revascularization via femoral access in old patients receiving antiplatelet therapy. Methods We evaluated outcomes of 122 consecutive patients more than 65 years old who underwent percutaneous peripheral artery angioplasty between January 2013 and June 2014. All patients received antiplatelet therapy. The closure method for the femoral access was manual compression(MC) in 64 patients and Perclose vascular closure device(VCD) in 58 patients. Procedural and in hospital vascular outcomes were assessed. Results The success rate of hemostasis was 94.8% in VCD and 100% in MC. Time for hemostasis was(3.5±0.3) min in VCD and(17.0±0.7) min in MC(P<0.01). Incidence of vascular complications including hematoma, pseudoaneurysm, deep venous thrombosis and vagovagal reflex was similar between the two groups(P>0.05). However, incidence of puncture site oozing was significantly increased(P<0.004) in VCD compared with MC. The overall complication rate was similar between the two groups(P=0.857). Conclusion Both MC and VCD(Perclose) can be safely and effectively applied for puncture site hemostasis in patients more than 65 years old undergoing antiplatelet therapy after peripheral artery revascularization via femoral artery access.
出处
《血管与腔内血管外科杂志》
2016年第1期55-59,共5页
Journal of Vascular and Endovascular Surgery
关键词
股动脉穿刺
止血
血管缝合器
外周介入
血管并发症
femoral artery puncture
hemostasis
vascular closure device
peripheral artery intervention
vascular complication
