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[双Perclose ProGlide交叉缝合与传统缝合在血管腔内主动脉修复术中穿刺部位闭合的效果比较]

[Effectiveness comparison between double Perclose ProGlide crossing suture and traditional suture for closure of puncture sites in endovascular aortic repair].

作者信息

Wei Ren, Xiong Jiang, Guo Wei, Liu Xiaoping, Zhang Hongpeng, Jia Xin

机构信息

Department of Vascular Surgery, General Hospital of Chinese PLA, Beijing 100853, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Aug;26(8):968-71.

Abstract

OBJECTIVE

To compare the advantages and disadvantages between double Perclose ProGlide crossing suture and traditional suture for the closure of 20F or 22F access points so as to provide a basis for selecting appropriate approach to repair the puncture points in endovascular aortic repair.

METHODS

Between June 2007 and May 2011, 103 patients (115 common femoral arteries) underwent endovascular aortic repair using sheaths of 20F or 22F (outer diameter); double Perclose ProGlide crossing suture was performed for closure of puncture sites in 57 cases (64 common femoral arteries) (double Perclose group) and traditional suture in 46 cases (51 common femoral arteries) (traditional group). There was no significant difference in age, gender, or disease duration between 2 groups (P > 0.05).

RESULTS

The operation time, blood loss, and hospitalization days of double Perclose group were significantly better than those of traditional group (P < 0.05). Ecchymoma in inguinal region and lymphatic leakage occurred in 5 cases (5 common femoral arteries) and 2 cases (2 common femoral arteries) of double Perclose group respectively, in 2 cases (2 common femoral arteries) and 6 cases (8 common femoral arteries) of traditional group respectively; no significant difference was found in the rate of the early complication between double Perclose group and traditional group (7.8% vs. 15.7%, chi2 = 1.76, P = 0.19). The technique success rate of double Perclose group was 96.9% (62/64), and was 100% (51/51) in traditional group, showing no significant difference (chi2 = 0.31, P = 0.50). All patients were followed up, 2-19 months (mean, 15 months) in double Perclose group and 2-18 months (mean, 14 months) in traditional group. Pseudoaneurysm occurred in the puncture region at 3 months in 1 case (1 common femoral artery) of double Perclose group, and incision and suture therapy was performed; no arteriostenosis or pseudoaneurysm occurred in other cases; and the rate of mid-term complication was 1.6% (1/64) in double Perclose group and was 0 in traditional group, showing no significant difference (P = 1.000).

CONCLUSION

Double Perclose ProGlide crossing suture has the same effectiveness to traditional surture in repairing the puncture point with 20F or 22F, but it is superior to traditional suture in reducing operation time, blood loss, and hospitalization days.

摘要

目的

比较双股Perclose ProGlide交叉缝合与传统缝合在闭合20F或22F穿刺点方面的优缺点,为血管腔内主动脉修复术中选择合适的穿刺点修复方法提供依据。

方法

2007年6月至2011年5月,103例患者(115条股总动脉)接受了外径为20F或22F鞘管的血管腔内主动脉修复术;57例患者(64条股总动脉)采用双股Perclose ProGlide交叉缝合闭合穿刺部位(双股Perclose组),46例患者(51条股总动脉)采用传统缝合(传统组)。两组患者在年龄、性别或病程方面无显著差异(P>0.05)。

结果

双股Perclose组的手术时间、失血量和住院天数均显著优于传统组(P<0.05)。双股Perclose组分别有5例患者(5条股总动脉)发生腹股沟区瘀斑和2例患者(2条股总动脉)发生淋巴漏,传统组分别有2例患者(2条股总动脉)和6例患者(8条股总动脉)发生;双股Perclose组与传统组早期并发症发生率无显著差异(7.8%对15.7%,χ2=1.76,P=0.19)。双股Perclose组的技术成功率为96.9%(62/64),传统组为100%(51/51),差异无统计学意义(χ2=0.31,P=0.50)。所有患者均获随访,双股Perclose组随访2-19个月(平均15个月),传统组随访2-18个月(平均14个月)。双股Perclose组1例患者(1条股总动脉)在术后3个月穿刺部位发生假性动脉瘤,行切开缝合治疗;其他病例未发生动脉狭窄或假性动脉瘤;双股Perclose组中期并发症发生率为1.6%(1/64),传统组为0,差异无统计学意义(P=1.000)。

结论

双股Perclose ProGlide交叉缝合在修复20F或22F穿刺点方面与传统缝合效果相同,但在缩短手术时间、减少失血量和住院天数方面优于传统缝合。

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