螺旋式与气囊式桡动脉压迫止血器应用效果的系统评价
|
摘要
[目的]系统评价经桡动脉穿刺术后螺旋式与气囊式桡动脉压迫止血器的应用效果。[方法]计算机检索Cochrane Library、PubMed、Ovid Medline、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库(VIP)中经桡动脉穿刺术后螺旋式与气囊式桡动脉压迫止血器应用效果的随机对照试验(RCT),经筛选文献、提取资料与评价质量后采用RevMan5.3软件进行Meta分析或仅进行描述性分析。[结果]最终纳入7篇RCT,共2 432例研究对象。Meta分析结果显示:螺旋式桡动脉止血器降低术后肢体肿胀率[OR=0.36,95%CI(0.24～0.55),P<0.05]、麻木率[OR=0.32,95%CI(0.18～0.56),P<0.05]、皮肤损伤发生率[OR=0.24,95%CI(0.10～0.56),P<0.05]的效果明显高于气囊式桡动脉止血器。[结论]螺旋式与气囊式桡动脉压迫止血器均能成功达到止血目的,但螺旋式桡动脉止血器对周围组织压迫更小,对皮肤损伤更小。
Objective:To systematically evaluate the effect of spiral and balloon radial artery compression hemostats after transradial artery puncture.Methods:Randomized controlled trials(RCTs) on the application of spiral and balloon radial artery compression hemostats after radial artery puncture were searched by computer in Cochrane Library,PubMed,Ovid Medline,Web of Science,CBM,CNKI,Wanfang and VIP databases.Literatures were screened,data were extracted and qualities were evaluated.RevMan 5.3 software was used for meta-analysis or only descriptive analysis.Results:Seven RCTs were included,including of 2432 subjects.Meta-analysis results showed that spiral radial artery hemostat reduced limb swelling rate[OR=0.36,95%CI(0.24,0.55),P<0.05],numbness rate[OR=0.32,95%CI(0.18,0.56),P<0.05],skin injury rate[OR=0.24,95%CI(0.10,0.56),P<0.05].The effects were better balloon radial artery hemostat at the same time.Conclusion:Both spiral and balloon radial artery compression hemostats can achieve the goal of hemostasis successfully,but spiral radial artery hemostats have less compression on surrounding tissues and less skin damage.
Objective:To systematically evaluate the effect of spiral and balloon radial artery compression hemostats after transradial artery puncture.Methods:Randomized controlled trials(RCTs) on the application of spiral and balloon radial artery compression hemostats after radial artery puncture were searched by computer in Cochrane Library,PubMed,Ovid Medline,Web of Science,CBM,CNKI,Wanfang and VIP databases.Literatures were screened,data were extracted and qualities were evaluated.RevMan 5.3 software was used for meta-analysis or only descriptive analysis.Results:Seven RCTs were included,including of 2432 subjects.Meta-analysis results showed that spiral radial artery hemostat reduced limb swelling rate[OR=0.36,95%CI(0.24,0.55),P<0.05],numbness rate[OR=0.32,95%CI(0.18,0.56),P<0.05],skin injury rate[OR=0.24,95%CI(0.10,0.56),P<0.05].The effects were better balloon radial artery hemostat at the same time.Conclusion:Both spiral and balloon radial artery compression hemostats can achieve the goal of hemostasis successfully,but spiral radial artery hemostats have less compression on surrounding tissues and less skin damage.
引文
[1] WILSON S J,MITCHELL A,GRAY T,et al.Patent haemostasis prevents radial artery occlusion in patients with an acute coronary syndrome[J].Int J Cardiol,2017,240:78-81.
[2] AMIN A P,HOUSE J A,SAFLEY D M,et al.Costs of transradial percutaneous coronary intervention[J].Jacc Cardiovasc Interv,2013,6(8):827-834.
[3] SATTI S R,VANCE A Z,GOLWALA S N,et al.Patient preference for transradial access over transfemoral access for cerebrovascular procedures[J].J Vasc Interv Neurol,2017,9(4):1-5.
[4] KANG S,HAN D,KIM S,et al.Hemostasis pad combined with compression device after transradial coronary procedures:a randomized controlled trial[J].PLoS ONE,2017,12(7):e181099.
[5] BRENER M I,BUSH A,MILLER J M,et al.Influence of radial versus femoral access site on coronary angiography and intervention outcomes:a systematic review and meta-analysis[J].Catheter Cardiovasc Interv,2017,90(7):1093-1104.
[6] DAI N,XU D C,HOU L,et al.A comparison of 2 devices for radial artery hemostasis after transradial coronary intervention[J].J Cardiovasc Nurs,2015,30(3):192-196.
[7] FERNANDEZ R S,LEE A.Effects of methods used to achieve hemostasis on radial artery occlusion following percutaneous coronary procedures:a systematic review[J].JBI Database System Rev Implement Rep,2017,15(3):738-764.
[8] YUN K,JEON W,KANG B,et al.Effectiveness of a compressive device in controlling hemorrhage following radial artery catheterization[J].Clin Exp Emerg Med,2015,2(2):104-109.
[9] 杨秀琴,朱晓萍,陆芸岚.两种桡动脉压迫器在冠状动脉造影术后止血中的应用[J].中华现代护理杂志,2012,18(15):1771-1773.
[10] HIGGINS J,GREEN S E.Cochrane handbook for systematic reviews of interventions version 5.1.0.the cochrane collaboration (Eds)[J].Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie,2011,5(2):S38.
[11] 张明亮,于海波,张立敏,等.旋压式桡动脉止血器在经桡动脉径路冠脉介入术后压迫止血效果分析[J].中华临床医师杂志,2016,10(4):215-216.
[12] 郑彩虹,翔董惠,军黄战,等.气囊式与旋压式桡动脉止血器应用效果比较分析[J].吉林医学,2016,37(9):2360.
[13] 龚东,马英东,李凌,等.TR Band和YM-RAO-1229压迫止血器在经桡动脉介入术后的止血效果比较[J].中国心血管病研究,2015,13(7):644-647.
[14] 郭磊.经皮冠状动脉介入诊疗术后两类桡动脉压迫止血装置应用比较[J].心理医生,2017,23(17):138-139.
[15] 赖浚兴,高伟栋,张学芳,等.LPYP20 压迫止血器和 Medplus 桡动脉止血带在经皮冠状动脉介入治疗后的止血效果对比[J].岭南心血管病杂志,2010,16(5):394-396.
[16] CONG X,HUANG Z,WU J,et al.Randomized comparison of 3 hemostasis techniques after transradial coronary intervention[J].J Cardiovasc Nurs,2016,31(5):445-451.
[17] 郭士遵,王宁夫,叶显华,等.经桡动脉冠脉介入诊疗后两种压迫器止血效果的比较[J].心脑血管病防治,2011,11(3):179-181.
[18] HAMON M,PRISTIPINO C,MARIO C D,et al.Consensus document on the radial approach in percutaneous cardiovascular interventions:position paper by the European association of percutaneous cardiovascular interventions and working groups on acute cardiac care and thrombosis of the European society of cardiology[J].Eurointervention,2013,8(11):1242-1251.
[19] KWOK C S,RAO S V,MYINT P K,et al.Major bleeding after percutaneous coronary intervention and risk of subsequent mortality:a systematic review and meta-analysis[J].Open Heart,2014,1(1):e21.
[20] 肖可喜,唐迎红,赵芝香,等.经桡动脉行冠状动脉介入术后应用不同止血器止血效果比较[J].护理研究,2015,29(1A):118-120.
[21] 郭俊,赵仙先,徐帝非,等.两类桡动脉压迫止血器临床应用效果分析[J].介入放射学杂志,2016,25(7):577-579.
[22] RASHID M,KWOK C S,PANCHOLY S,et al.Radial artery occlusion after transradial interventions:a systematic review and meta-analysis[J].Journal of the American Heart Association,2016,5(1):e2686.
[23] BERTRAND O F,BERNAT I.Radial artery occlusion:still the Achille′s heel of transradial approach or is it?[J].Coron Artery Dis,2015,26(2):97-98.
[24] 张存,魏国芬.经桡动脉路径行冠状动脉介入治疗止血的研究进展[J].岭南心血管病杂志,2014,20(3):402-404.
[25] VOON V,AYYAZULHAQ M,CAHILL C,et al.Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel air-inflation technique[J].World J Cardiol,2017,9(11):807-812.
[26] PANCHOLY S B,PATEL T M.Effect of duration of hemostatic compression on radial artery occlusion after transradial access[J].Catheter Cardiovasc Interv,2012,79(1):78-81.
[27] RATHORE S,STABLES R H,PAURIAH M,et al.Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention:a randomized study[J].Jacc Cardiovasc Interv,2010,3(5):475-483.
[28] PANCHOLY S B,BERTRAND O F,PATEL T.Comparison of a priori versus provisional heparin therapy on radial artery occlusion after transradial coronary angiography and patent hemostasis (from the PHARAOH study)[J].Am J Cardiol,2012,110(2):173-176.
[29] AMINIAN A,SAITO S,TAKAHASHI A,et al.Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients:a substudy from RAP and BEAT (radial artery patency and bleeding,efficacy,adverse event) randomized multicenter trial[J].Catheter Cardiovasc Interv,2018,92:844-851.
[2] AMIN A P,HOUSE J A,SAFLEY D M,et al.Costs of transradial percutaneous coronary intervention[J].Jacc Cardiovasc Interv,2013,6(8):827-834.
[3] SATTI S R,VANCE A Z,GOLWALA S N,et al.Patient preference for transradial access over transfemoral access for cerebrovascular procedures[J].J Vasc Interv Neurol,2017,9(4):1-5.
[4] KANG S,HAN D,KIM S,et al.Hemostasis pad combined with compression device after transradial coronary procedures:a randomized controlled trial[J].PLoS ONE,2017,12(7):e181099.
[5] BRENER M I,BUSH A,MILLER J M,et al.Influence of radial versus femoral access site on coronary angiography and intervention outcomes:a systematic review and meta-analysis[J].Catheter Cardiovasc Interv,2017,90(7):1093-1104.
[6] DAI N,XU D C,HOU L,et al.A comparison of 2 devices for radial artery hemostasis after transradial coronary intervention[J].J Cardiovasc Nurs,2015,30(3):192-196.
[7] FERNANDEZ R S,LEE A.Effects of methods used to achieve hemostasis on radial artery occlusion following percutaneous coronary procedures:a systematic review[J].JBI Database System Rev Implement Rep,2017,15(3):738-764.
[8] YUN K,JEON W,KANG B,et al.Effectiveness of a compressive device in controlling hemorrhage following radial artery catheterization[J].Clin Exp Emerg Med,2015,2(2):104-109.
[9] 杨秀琴,朱晓萍,陆芸岚.两种桡动脉压迫器在冠状动脉造影术后止血中的应用[J].中华现代护理杂志,2012,18(15):1771-1773.
[10] HIGGINS J,GREEN S E.Cochrane handbook for systematic reviews of interventions version 5.1.0.the cochrane collaboration (Eds)[J].Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie,2011,5(2):S38.
[11] 张明亮,于海波,张立敏,等.旋压式桡动脉止血器在经桡动脉径路冠脉介入术后压迫止血效果分析[J].中华临床医师杂志,2016,10(4):215-216.
[12] 郑彩虹,翔董惠,军黄战,等.气囊式与旋压式桡动脉止血器应用效果比较分析[J].吉林医学,2016,37(9):2360.
[13] 龚东,马英东,李凌,等.TR Band和YM-RAO-1229压迫止血器在经桡动脉介入术后的止血效果比较[J].中国心血管病研究,2015,13(7):644-647.
[14] 郭磊.经皮冠状动脉介入诊疗术后两类桡动脉压迫止血装置应用比较[J].心理医生,2017,23(17):138-139.
[15] 赖浚兴,高伟栋,张学芳,等.LPYP20 压迫止血器和 Medplus 桡动脉止血带在经皮冠状动脉介入治疗后的止血效果对比[J].岭南心血管病杂志,2010,16(5):394-396.
[16] CONG X,HUANG Z,WU J,et al.Randomized comparison of 3 hemostasis techniques after transradial coronary intervention[J].J Cardiovasc Nurs,2016,31(5):445-451.
[17] 郭士遵,王宁夫,叶显华,等.经桡动脉冠脉介入诊疗后两种压迫器止血效果的比较[J].心脑血管病防治,2011,11(3):179-181.
[18] HAMON M,PRISTIPINO C,MARIO C D,et al.Consensus document on the radial approach in percutaneous cardiovascular interventions:position paper by the European association of percutaneous cardiovascular interventions and working groups on acute cardiac care and thrombosis of the European society of cardiology[J].Eurointervention,2013,8(11):1242-1251.
[19] KWOK C S,RAO S V,MYINT P K,et al.Major bleeding after percutaneous coronary intervention and risk of subsequent mortality:a systematic review and meta-analysis[J].Open Heart,2014,1(1):e21.
[20] 肖可喜,唐迎红,赵芝香,等.经桡动脉行冠状动脉介入术后应用不同止血器止血效果比较[J].护理研究,2015,29(1A):118-120.
[21] 郭俊,赵仙先,徐帝非,等.两类桡动脉压迫止血器临床应用效果分析[J].介入放射学杂志,2016,25(7):577-579.
[22] RASHID M,KWOK C S,PANCHOLY S,et al.Radial artery occlusion after transradial interventions:a systematic review and meta-analysis[J].Journal of the American Heart Association,2016,5(1):e2686.
[23] BERTRAND O F,BERNAT I.Radial artery occlusion:still the Achille′s heel of transradial approach or is it?[J].Coron Artery Dis,2015,26(2):97-98.
[24] 张存,魏国芬.经桡动脉路径行冠状动脉介入治疗止血的研究进展[J].岭南心血管病杂志,2014,20(3):402-404.
[25] VOON V,AYYAZULHAQ M,CAHILL C,et al.Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel air-inflation technique[J].World J Cardiol,2017,9(11):807-812.
[26] PANCHOLY S B,PATEL T M.Effect of duration of hemostatic compression on radial artery occlusion after transradial access[J].Catheter Cardiovasc Interv,2012,79(1):78-81.
[27] RATHORE S,STABLES R H,PAURIAH M,et al.Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention:a randomized study[J].Jacc Cardiovasc Interv,2010,3(5):475-483.
[28] PANCHOLY S B,BERTRAND O F,PATEL T.Comparison of a priori versus provisional heparin therapy on radial artery occlusion after transradial coronary angiography and patent hemostasis (from the PHARAOH study)[J].Am J Cardiol,2012,110(2):173-176.
[29] AMINIAN A,SAITO S,TAKAHASHI A,et al.Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients:a substudy from RAP and BEAT (radial artery patency and bleeding,efficacy,adverse event) randomized multicenter trial[J].Catheter Cardiovasc Interv,2018,92:844-851.