Chang Ki-Sul, Kim Byung-Sik, Shin Jinho, Lim Young-Hyo, Shin Jeong-Hun, Lee Yonggu, Kim Kyung-Soo
Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, South Korea.
Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea.
Minerva Cardioangiol. 2020 Feb;68(1):34-41. doi: 10.23736/S0026-4725.19.05022-9. Epub 2019 Nov 28.
Transradial vascular access is widely used due to advantages such as facile hemostasis and reduced bed rest time. Accordingly, several hemostatic devices have been introduced for transradial vascular access. However, the pain caused by hemostatic compression has not yet been resolved. The objective of this study was to determine the optimal compression pressure to minimize pain at the hemostasis site without increasing complications after transradial catheterization.
A total of 86 patients who underwent transradial catheterization from November 2014 to March 2015 were prospectively enrolled in this study. In group I (N.=42), the radial arteries were compressed by adjusting the air volume to reach systolic blood pressure plus 20 mmHg. For group II (N.=44), "conventional hemostasis" was performed by injecting a fixed volume (15 mL) of air into the air bag of the TR band. Complications, including pain, rebleeding, hematoma, and radial artery occlusion, were compared between the two groups. In addition, the pain level at the hemostasis site was assessed using a visual analog scale.
The visual analog scale of group I was significantly lower than that of group II (1.548±1.549 vs. 2.466±1.682, P=0.01 at application; 1.202±1.700 vs. 2.818±2.060, P<0.001 at removal). The other complications were not significantly different between the two groups.
Compared to conventional hemostasis, pressure-controlled hemostasis with systolic blood pressure plus 20 mmHg significantly reduced pain at the hemostasis site after transradial vascular access without increasing the incidence of other complications.
由于诸如止血简便和减少卧床休息时间等优点，经桡动脉血管通路被广泛应用。相应地，已经引入了几种用于经桡动脉血管通路的止血装置。然而，止血压迫所引起的疼痛尚未得到解决。本研究的目的是确定最佳压迫压力，以在经桡动脉导管插入术后不增加并发症的情况下，使止血部位的疼痛最小化。
2014年11月至2015年3月期间接受经桡动脉导管插入术的86例患者被前瞻性纳入本研究。在第一组（N = 42）中，通过调节空气量来压迫桡动脉，使其达到收缩压加20 mmHg。对于第二组（N = 44），通过向TR带的气囊中注入固定体积（15 mL）的空气来进行“传统止血”。比较两组之间的并发症，包括疼痛、再出血、血肿和桡动脉闭塞。此外，使用视觉模拟量表评估止血部位的疼痛程度。
第一组的视觉模拟量表显著低于第二组（应用时为1.548±1.549对2.466±1.682，P = 0.共01；移除时为1.202±1.700对2.818±2.060，P<0.001）。两组之间的其他并发症无显著差异。
与传统止血相比，收缩压加20 mmHg的压力控制止血在经桡动脉血管通路术后显著减轻了止血部位的疼痛，且未增加其他并发症的发生率。
