Simon A, Bumgarner B, Clark K, Israel S
Saint Joseph's Hospital of Atlanta, GA, USA.
Am J Crit Care. 1998 Jul;7(4):308-13.
Most cardiac catheterizations are performed via femoral artery access. Reported rates of both peripheral vascular complications and success rates for the use of manual and mechanical compression techniques to achieve femoral artery hemostasis after cardiac catheterization vary.
To determine is use of a mechanical clamp is as effective as standard manual pressure for femoral artery hemostasis after cardiac catheterization.
Subjects consisted of 720 patients from 2 community hospitals who had elective diagnostic cardiac catheterization via the femoral artery. The control group (n=343) received manual compression for hemostasis; the study group (n=377) received mechanical compression. Standard protocols were used for the 2 compression techniques. Pressure was applied for a minimum of 10 minutes for 5F and 6F sheaths and catheters and for a minimum of 15 minutes for 7F and 8F sheaths and catheters. Prospective data were collected and analyzed for each patients, including sheath or catheter size, blood pressure, height, weight, age, time from administration of local anesthetic to successful cannulation of the femoral artery, anticoagulation status, total compression time, physician performing the catheterization procedure, nurse or technician who obtained hemostasis, and complications. In follow-up, patients were asked site-specific and functional status questions 1 to 2 days after the catheterization procedure and again 3 days after the catheterization procedure.
Data were analyzed by using frequency distributions, measures of central tendency, and measures of variability. Only 1 difference between the 2 groups was significant: manual compression time was 14.93 +/- minutes, whereas mechanical compression time was 17.13 +/- minutes.
Mechanical compression is as effective as manual compression for femoral artery hemostasis after cardiac catheterization.
大多数心脏导管插入术通过股动脉入路进行。心脏导管插入术后，使用手动和机械压迫技术实现股动脉止血的外周血管并发症发生率和成功率的报道各不相同。
确定心脏导管插入术后使用机械夹与标准手动压迫在股动脉止血方面是否同样有效。
研究对象包括来自2家社区医院的720例行择期经股动脉诊断性心脏导管插入术的患者。对照组（n = 343）接受手动压迫止血；研究组（n = 377）接受机械压迫。两种压迫技术均采用标准方案。对于5F和6F鞘管及导管，压迫至少10分钟；对于7F和8F鞘管及导管，压迫至少15分钟。收集并分析每位患者的前瞻性数据，包括鞘管或导管尺寸、血压、身高、体重、年龄、从局部麻醉给药到股动脉成功插管的时间、抗凝状态、总压迫时间、实施导管插入术的医生、实现止血的护士或技术人员以及并发症。在随访中，在导管插入术后1至2天以及再次在导管插入术后3天询问患者特定部位和功能状态的问题。
采用频率分布、集中趋势测量和变异性测量对数据进行分析。两组之间只有1个差异具有统计学意义：手动压迫时间为14.93±分钟，而机械压迫时间为17.13±分钟。
心脏导管插入术后，机械压迫在股动脉止血方面与手动压迫同样有效。
