Yang Xiu-Chun, Qin Yue-Lan, Xiang Hua, Mo Wei, Huang Ai-Zhen, Xiang Bin, Xu Yuan, Zhu Zhi-Lan
Department of Interventional Vascular Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University.
Nursing Management Department, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University.
Tohoku J Exp Med. 2023 Oct 7;261(2):109-116. doi: 10.1620/tjem.2023.J054. Epub 2023 Jul 6.
This study aimed to identify the risk factors associated with puncture site bleeding following percutaneous puncture of the common femoral artery during interventional treatment of cerebrovascular disease (CVD). A retrospective analysis was conducted on 710 patients who underwent interventional treatment for CVD via femoral artery puncture. Among them, 26 individuals (3.66%) experienced bleeding at the femoral artery puncture site. Binary logistic regression analysis was performed to identify risk factors for puncture site bleeding. The impact of salt bag compression on postoperative bleeding was evaluated in patients with intermediate to high bleeding risk scores. The bleeding group showed higher blood pressure, lower platelet counts, longer prothrombin time and activated partial thromboplastin time, as well as a higher prevalence of larger vascular sheath sizes and variations in the timing of anti-coagulant and anti-platelet therapy administration. The bleeding risk score was higher in the bleeding group, indicating its predictive value for bleeding risk. Higher bleeding risk score, unstable blood pressure, repeated puncture, and serious vascular conditions were significant risk factors for puncture site bleeding. Application of salt bag compression for a duration of 2 hours reduced postoperative puncture site bleeding in patients with intermediate to high bleeding risk scores. Our study identified several significant risk factors for puncture site bleeding after cerebral vascular intervention via femoral artery puncture, including the bleeding risk score, blood pressure, repeated puncture, and vascular conditions. Implementing salt bag compression as a preventive measure can help mitigate bleeding complications in these high-risk patients.
本研究旨在确定脑血管疾病（CVD）介入治疗期间经皮穿刺股总动脉后穿刺部位出血的相关危险因素。对710例经股动脉穿刺进行CVD介入治疗的患者进行回顾性分析。其中，26例（3.66%）在股动脉穿刺部位出现出血。采用二元逻辑回归分析确定穿刺部位出血的危险因素。对出血风险评分中等至高的患者评估盐袋压迫对术后出血的影响。出血组患者血压更高、血小板计数更低、凝血酶原时间和活化部分凝血活酶时间更长，以及更大尺寸血管鞘的使用比例更高，抗凝和抗血小板治疗给药时间存在差异。出血组的出血风险评分更高，表明其对出血风险具有预测价值。更高的出血风险评分、血压不稳定、反复穿刺和严重血管状况是穿刺部位出血的显著危险因素。对出血风险评分中等至高的患者应用盐袋压迫2小时可减少术后穿刺部位出血。我们的研究确定了经股动脉穿刺进行脑血管介入治疗后穿刺部位出血的几个重要危险因素，包括出血风险评分、血压、反复穿刺和血管状况。实施盐袋压迫作为预防措施有助于减轻这些高危患者的出血并发症。
