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缺血性脑血管介入术后不同止血方法的应用效果比较

Comparison of Application Effects of Different Hemostasis Methods After Ischemic Cerebrovascular Intervention.

作者信息

Zhou Yanli, Xu Chenghua

机构信息

Department of Neurology, Taizhou First People's Hospital, Taizhou, China.

出版信息

Front Surg. 2022 Mar 7;9:850139. doi: 10.3389/fsurg.2022.850139. eCollection 2022.

Abstract

OBJECTIVE

To explore the effects of two different hemostasis methods, namely, arterial compression devices and vascular closure devices, in the ischemic cerebrovascular intervention to provide a theoretical basis for clinical selection of hemostasis methods.

METHODS

A total of 302 patients who underwent ischemic cerebrovascular intervention in our hospital from January 2016 to December 2020 were selected as the research subjects and randomly divided into the control group ( = 151) and the observation group ( = 151). The patients in both groups underwent cerebrovascular intervention. The patients in the control group were treated with an artery compressor for hemostasis after the operation, while those in the observation group were treated with vascular closure devices for hemostasis. The hemostatic indexes and vascular parameters at the puncture site before and after the operation were compared between the two groups. The comfort level of the patients was assessed at 6, 12, and 24 h after the operation with the Kolcaba Comfort Scale score, and the postoperative complications were recorded.

RESULTS

There was no significant difference in the success rate of hemostasis between the two groups ( > 0.05). The hemostatic time and immobilization time of (2.69 ± 0.62) min and (4.82 ± 0.93) h in the observation group were lower than those in the control group with (16.24 ± 3.58) min and (7.94 ± 1.86) h ( < 0.05). The differences in the minimum inner diameter of the puncture site and its nearby vessels and the peak velocity of blood flow between the two groups before and after the operation were not statistically significant within or between groups ( > 0.05). The scores of the Kolcaba comfort scale in the observation group (80.16 ± 8.49) and (93.65 ± 9.26) at 6 and 12 h, respectively, after the operation, were higher than those in the control groups (72.08 ± 7.54) and (85.49 ± 8.63) ( < 0.05). The 24 h postoperative Kolcaba comfort scale score was (97.54 ± 9.86) in the observation group and (96.82 ± 9.64) in the control group, and the difference was not statistically significant ( > 0.05). In the control group, there were 7 cases of dysuria, 12 cases of low back pain, 14 cases of sleep disorder, 20 cases of mental stress, and 5 cases of wound bleeding, and the total incidence of complications was 38.41% (58/151). In the observation group, there were 4 cases of dysuria, 8 cases of low back pain, 10 cases of sleep disorder, 14 cases of mental stress, and 3 cases of wound bleeding, and the total incidence of complications was 25.83% (39/151). The total incidence of complications in the observation group was lower than that in the control group ( < 0.05).

CONCLUSION

For patients with ischemic cerebrovascular disease undergoing femoral artery puncture intervention, the use of vascular closure devices can stop the bleeding quickly, which can significantly shorten the bleeding time, and the postoperative braking time of patients is short, with high comfort and fewer complications.

摘要

目的

探讨动脉压迫装置和血管闭合装置两种不同止血方法在缺血性脑血管介入治疗中的效果,为临床选择止血方法提供理论依据。

方法

选取2016年1月至2020年12月在我院接受缺血性脑血管介入治疗的302例患者作为研究对象,随机分为对照组(n = 151)和观察组(n = 151)。两组患者均接受脑血管介入治疗。对照组患者术后采用动脉压迫器止血,观察组患者采用血管闭合装置止血。比较两组患者手术前后穿刺部位的止血指标和血管参数。采用Kolcaba舒适量表评分在术后6、12和24 h评估患者的舒适度,并记录术后并发症。

结果

两组止血成功率差异无统计学意义(P > 0.05)。观察组的止血时间(2.69 ± 0.62)min和制动时间(4.82 ± 0.93)h低于对照组的(16.24 ± 3.58)min和(7.94 ± 1.86)h(P < 0.05)。两组手术前后穿刺部位及其附近血管的最小内径和血流峰值速度在组内及组间差异均无统计学意义(P > 0.05)。观察组术后6 h和12 h的Kolcaba舒适量表评分分别为(80.16 ± 8.49)和(93.65 ± 9.26),高于对照组的(72.08 ± 7.54)和(85.49 ± 8.63)(P < 0.05)。观察组术后24 h的Kolcaba舒适量表评分为(97.54 ± 9.86),对照组为(96.82 ± 9.64),差异无统计学意义(P > 0.05)。对照组发生排尿困难7例、腰痛12例、睡眠障碍14例、精神紧张20例、伤口出血5例,并发症总发生率为38.41%(58/151)。观察组发生排尿困难4例、腰痛8例、睡眠障碍10例、精神紧张14例、伤口出血3例,并发症总发生率为25.83%(39/151)。观察组并发症总发生率低于对照组(P < 0.05)。

结论

对于接受股动脉穿刺介入治疗的缺血性脑血管病患者,使用血管闭合装置能快速止血,可显著缩短止血时间,患者术后制动时间短,舒适度高,并发症少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c44b/8936086/471b046c2181/fsurg-09-850139-g0001.jpg

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