Critical Care Nursing, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Medical Surgical Nursing, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Vasc Nurs. 2020 Mar;38(1):2-8. doi: 10.1016/j.jvn.2020.01.001. Epub 2020 Feb 19.
Different methods are available for the closure of the femoral artery after catheterization. The present study aimed at comparing the effect of manual compression (MC) and closure pad (CP) on vascular complications (hematoma and bleeding) of coronary angiography.
In the current clinical trial, a total of 238 patients who were candidates for angiography were randomly assigned to the MC and CP groups. In the MC group, after removal of the arterial sheath, the arterial puncture site was manually compressed for 5-10 minutes and hemostasis was achieved. In the CP group, after removal of the arterial sheath, the arterial puncture site was first manually compressed for 5-10 minutes and initial coagulation was achieved. Then, to continue the coagulation process, a CP was attached to the artery puncture site. Postangiography complications including bleeding and hematoma were monitored in both groups immediately and up to 24 hours after hemostasis. Data were analyzed by SPSS-18 software.
After angiography, 7 (9.5%) and 5 (2.4%) patients had hematoma in the MC and CP groups, respectively; however, no significant difference was found between the groups. Rebleeding after hemostasis was observed in 2 (7.1%) patients in the MC group, but none of the subjects in the CP group had rebleeding. There was no significant difference in bleeding volume between the groups.
The results indicated the same efficacy of MC and CP methods in the prevention of postangiography vascular complications. Given the advantages of CP such as the possibility of changing the position in bed and increased physical comfort in the patient, this method is recommended for angiography and catheterization.
股动脉穿刺后有多种方法闭合。本研究旨在比较手动压迫（MC）和闭合垫（CP）对冠状动脉造影血管并发症（血肿和出血）的影响。
在这项临床试验中，共有 238 名符合造影条件的患者被随机分为 MC 组和 CP 组。MC 组在取出动脉鞘后，手动压迫动脉穿刺部位 5-10 分钟以止血。CP 组在取出动脉鞘后，首先手动压迫动脉穿刺部位 5-10 分钟以达到初步止血，然后使用 CP 覆盖动脉穿刺部位以继续止血过程。在两组中，立即并在止血后 24 小时内监测血管造影后并发症，包括出血和血肿。
在血管造影后，MC 组有 7（9.5%）例和 CP 组有 5（2.4%）例患者出现血肿，但两组之间无显著差异。MC 组有 2（7.1%）例患者在止血后再次出血，但 CP 组无一例患者再次出血。两组的出血量无显著差异。
MC 和 CP 方法在预防血管造影后并发症方面具有相同的效果。考虑到 CP 如改变体位和增加患者舒适度的可能性等优点，建议将 CP 方法用于血管造影和导管插入术。
