止血贴与止血气囊对经桡动脉冠状动脉造影患者止血效果的对比研究
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摘要
目的对比止血贴与止血气囊对经桡动脉冠状动脉影患者的止血效果。方法选取2018年5—6月在上海市第一人民医院行经桡动脉冠状动脉造影的患者160例,根据止血方法分为A组和B组,每组80例。A组患者采用止血贴进行止血,B组患者采用止血气囊进行止血;两组患者均于造影后6～8 h解除。比较两组患者穿刺点压迫时间、住院时间、疼痛发生率、止血成功率及并发症发生情况。结果两组患者穿刺点压迫时间、住院时间、疼痛发生率、止血成功率比较,差异无统计学意义(P>0.05)。A组患者压迫点皮肤损伤及压疮发生率低于B组(P<0.05);两组患者压迫背侧皮肤损伤及压疮、急性桡动脉闭塞、出血及血肿、拔管迷走神经反射、皮下瘀斑发生率比较,差异无统计学意义(P>0.05)。结论止血贴与止血气囊对经桡动冠状动脉影患者的止血效果相似,但与止血贴相比,止血气囊所致压迫点皮肤损伤及压疮发生风险较高。
Objective To compare the hemostatic effect in patients undergoing transradial artery coronary angiography between hemostatic bandage and hemostatic balloon. Methods A total of 160 patients undergoing transradial artery coronary angiography were selected in the First People's Hospital of Shanghai from May to June 2018,and they were divided into A group and B group according to the hemostatic methods,with 80 cases in each group. Patients in A group received hemostatic bandage for hemostasis,while patients in B group received hemostatic balloon for hemostasis;hemostatic bandage or hemostatic bandage was removed 6 to 8 hours after coronary angiography. Compression time of puncture point,hospital stays,incidence of pain,success rate of hemostasis and incidence of complications were compared between the two groups. Results No statistically significant difference of compression time of puncture point,hospital stays,incidence of pain or success rate of hemostasis was found between the two groups(P>0.05).Incidence of skin damage and pressure sores of pressure point in A group was statistically significantly lower than that in B group(P<0.05),while no statistically significant difference of incidence of skin damage and pressure sores of pressure dorsal part,acute radial artery occlusion,bleeding and hematoma,extubation related vagus reflex or subcutaneous ecchymosis was found between the two groups(P>0.05). Conclusion Hemostatic bandage has similar hemostatic effect with hemostatic balloon in patients undergoing transradial artery coronary angiography,but compared with hemostatic bandage,risk of skin damage and pressure sores of pressure point caused by hemostatic balloon is significantly higher.
Objective To compare the hemostatic effect in patients undergoing transradial artery coronary angiography between hemostatic bandage and hemostatic balloon. Methods A total of 160 patients undergoing transradial artery coronary angiography were selected in the First People's Hospital of Shanghai from May to June 2018,and they were divided into A group and B group according to the hemostatic methods,with 80 cases in each group. Patients in A group received hemostatic bandage for hemostasis,while patients in B group received hemostatic balloon for hemostasis;hemostatic bandage or hemostatic bandage was removed 6 to 8 hours after coronary angiography. Compression time of puncture point,hospital stays,incidence of pain,success rate of hemostasis and incidence of complications were compared between the two groups. Results No statistically significant difference of compression time of puncture point,hospital stays,incidence of pain or success rate of hemostasis was found between the two groups(P>0.05).Incidence of skin damage and pressure sores of pressure point in A group was statistically significantly lower than that in B group(P<0.05),while no statistically significant difference of incidence of skin damage and pressure sores of pressure dorsal part,acute radial artery occlusion,bleeding and hematoma,extubation related vagus reflex or subcutaneous ecchymosis was found between the two groups(P>0.05). Conclusion Hemostatic bandage has similar hemostatic effect with hemostatic balloon in patients undergoing transradial artery coronary angiography,but compared with hemostatic bandage,risk of skin damage and pressure sores of pressure point caused by hemostatic balloon is significantly higher.
引文
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[15]陆芸岚.介入诊疗术后应用壳聚糖敷料联合充气止血绷带的研究[J].护理研究,2012,26(10):901-902.DOI:10.3969/j.issn.1009-6493.2012.10.018.
[16]郑彩虹,董惠翔,黄战军,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):2360-2361.DOI:10.3969/j.issn.1004-0412.2016.09.161.
[2]曾辉,朱艳霞,晋辉,等.复方利多卡因乳膏在经桡动脉穿刺诊疗中的临床应用[J].河南医学高等专科学校学报,2017,29(5):425-427.DOI:10.3969/j.issn.1008-9276.2017.05.005.
[3]张艳,王翠平,王亚斌,等.1例肝癌合并冠心病患者经肱动脉冠状动脉介入术后上肢严重出血的救治与护理[J].中华护理杂志,2017,52(2):158-160.DOI:10.3761/j.issn.0254-1769.2017.02.006.
[4]李萍,温切木·沙迪克,姚虹,等.经桡动脉穿刺冠状动脉介入术后患者腕部绷带首次减压最佳时间的研究[J].中华现代护理杂志,2016,22(4):497-500.DOI:10.3760/cma.j.issn.1674-2907.2016.04.014.
[5]BRANCHEAU D,JAIN S K A,ALEXANDER P B.Same-day dual radial artery puncture examination in patients requiring percutaneous coronary intervention and the incidence of radial artery occlusion[J].Ther Adv Cardiovasc Dis,2018,12(3):77-84.DOI:10.1177/1753944717749738.
[6]王军贤.改良后的Seldinger法行桡动脉穿刺的临床观察[J].中国临床新医学,2017,10(7):627-629.DOI:10.3969/j.issn.1674-3806.2017.07.09.
[7]李婷,尹秋馨,陈佳云,等.TR-Band压迫时间对桡动脉穿刺术后并发症预防效果的系统评价[J].护理与康复,2017,16(11):1135-1139,1143.
[8]张林猛,孟立军,曹俊强,等.关键技术在经桡动脉途径行经皮冠状动脉介入治疗中的应用[J].岭南心血管病杂志,2018,24(4):393-396,407.DOI:10.3969/j.issn.1007-9688.2018.04.07.
[9]周玉杰,刘巍.2018年欧洲心脏协会和欧洲心胸外科协会血运重建指南解读[J].中国介入心脏病学杂志,2018,26(9):497-500.DOI:10.3969/j.issn.1004-8812.2018.09.004.
[10]马凤兰,图雅.老年冠心病患者经桡动脉介入术后并发症的护理[J].内蒙古民族大学学报(自然科学版),2009,24(4):457-458.DOI:10.3969/j.issn.1671-0185.2009.04.030.
[11]罗学会.冠状动脉介入术后桡动脉止血研究进展[J].护理研究,2018,32(12):1845-1847.
[12]陈静梅,李秀琼,罗卫平,等.不同放气时间对经桡动脉介入术压迫止血的影响[J].护士进修杂志,2015,30(5):465-466.DOI:10.16821/j.cnki.hsjx.2015.05.034.
[13]张燕,刘霞,陈绣.经皮冠状动脉介入治疗术后替罗非班应用与桡动脉穿刺处压迫止血减压时间的临床研究和护理观察[J].血栓与止血学,2014,20(6):339-340,343.DOI:10.3969/j.issn.1009-6213.2014.06.020.
[14]纪明,陈宏伟.脉搏血氧仪在老年冠心病患者经桡动脉途径经皮冠状动脉介入治疗术后桡动脉压迫止血中的应用效果[J].实用心脑肺血管病杂志,2017,25(9):89-91.DOI:10.3969/j.issn.1008-5971.2017.09.022.
[15]陆芸岚.介入诊疗术后应用壳聚糖敷料联合充气止血绷带的研究[J].护理研究,2012,26(10):901-902.DOI:10.3969/j.issn.1009-6493.2012.10.018.
[16]郑彩虹,董惠翔,黄战军,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):2360-2361.DOI:10.3969/j.issn.1004-0412.2016.09.161.