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经桡动脉冠状动脉导管插入术后TR Band与一种新型止血压迫装置的对比研究。

A comparative study of TR Band and a new hemostatic compression device after transradial coronary catheterization.

作者信息

Wang Yong, Tang Jing, Ni Jingwei, Chen Xin, Zhang Ruiyan

机构信息

Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

出版信息

J Interv Med. 2019 Apr 30;1(4):221-228. doi: 10.19779/j.cnki.2096-3602.2018.04.05. eCollection 2018 Nov.

Abstract

Transradial coronary catheterization has proved to be safe and effective in clinical practice. Various hemostatic compressive devices have been used in subsequent procedures. The objective of this study was to compare the efficacy and safety of a new hemostatic compression device and the widely used TR Band. A total of 118 patients were divided randomly into two groups: TR Band and the new hemostatic compression device. Efficacy of hemostasis, patient comfort, local vascular dysfunction, and radial artery occlusion (RAO) were evaluated and compared between groups. Occurrence of errhysis or hematoma did not significantly differ between groups (13.6% vs. 11.9%, P = 0.782). Fewer patients had moderate to severe pain or moderate to severe numbness in the new hemostatic compression device group (1.7% vs. 22.0%; 1.7% vs. 18.6%, respectively). Pulse loss between distal artery and device was lower in the new hemostatic compression device group (5.1% vs. 22.0%, P = 0.007), and fewer patients experienced obstruction of venous reflux compared with the TR Band group (6.8% vs. 25.4%, P = 0.006). Combined incidence of RAO at discharge was 7.6%, and was lower in the new hemostatic compression device group (1.7% vs. 13.6%, P = 0.015). In contrast to the TR Band, application of the new hemostatic compression device was independently associated with lower incidence of RAO at discharge (odds ratio: 0.062, 95% confidence interval: 0.006-0.675, P = 0.022). Both the new hemostatic compression device and the TR Band can efficiently achieve hemostasis following transradial coronary catheterization. However, fewer patients felt discomfort with application of the new hemostatic compression device. Pulse loss in the artery distal to the compression device, obstruction of venous reflux, and RAO occurred significantly less often with application of the new device.

摘要

经桡动脉冠状动脉介入治疗在临床实践中已被证明是安全有效的。在后续操作中使用了各种止血压迫装置。本研究的目的是比较一种新型止血压迫装置与广泛使用的TR Band的疗效和安全性。总共118例患者被随机分为两组:TR Band组和新型止血压迫装置组。对两组之间的止血效果、患者舒适度、局部血管功能障碍和桡动脉闭塞(RAO)进行了评估和比较。两组之间出血或血肿的发生率无显著差异(13.6%对11.9%,P = 0.782)。新型止血压迫装置组中出现中度至重度疼痛或中度至重度麻木的患者较少(分别为1.7%对22.0%;1.7%对18.6%)。新型止血压迫装置组中远端动脉与装置之间的脉搏消失率较低(5.1%对22.0%,P = 0.007),与TR Band组相比,经历静脉回流受阻的患者较少(6.8%对25.4%,P = 0.006)。出院时RAO的合并发生率为7.6%,新型止血压迫装置组较低(1.7%对13.6%,P = 0.015)。与TR Band相比,新型止血压迫装置的应用与出院时较低的RAO发生率独立相关(比值比:0.062,95%置信区间:0.006 - 0.675,P = 0.022)。新型止血压迫装置和TR Band在经桡动脉冠状动脉介入治疗后均能有效实现止血。然而,使用新型止血压迫装置时患者感到不适的较少。使用新型装置时,压迫装置远端动脉的脉搏消失、静脉回流受阻和RAO的发生明显较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3303/8586707/76581f73d56a/gr1.jpg

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