经皮缝合装置在经皮冠状动脉介入术中的应用价值.pdf

156-SouthChinaJournalofCardiovascularDiseases，June2005_．Vol1±D．
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·论著·
经皮缝合装置在经皮冠状动脉介入术中
的应用价值

侯玉清，周忠江，黄铮，郭志刚，贾满盈(南方医科大学南方医院心内科，广州510515)

摘要：目的评价经皮缝合装置(Percloser缝合器)止血的安全性、有效性及临床应用价值。方法选取
2002年4月～2005年3月所做的经皮冠状动脉介人治疗患者504例。按止血方法不同分为传统压迫止血
组254例和血管缝合组250例，分析两组在止血时间、制动时间、总卧床时间及各种并发症的差异。结果
缝合法与压迫法比较，止血时间：压迫组为(25+_6)分钟，血管缝合组为：(6．O±0．4)分钟(P<O．001)；下肢制
动时间：压迫组为(26+_4)小时，血管缝合组为(4．0±1．2)小时(P<O．001)；总卧床时间：压迫组为(25．2±
4．5)小时，血管缝合组(6．0±1．3)小时(P<0．001)。压迫组术后并发症如出血、血肿、迟发出血(第3日～1
周)、迷走反射、皮肤溃烂等，明显高于缝合组(P<0．001)。结论Percloser缝合器止血用于冠状动脉造影及
经皮腔内冠状动脉成形术或支架术后患者，止血时间与卧床制动时间明显缩短，并发症少，安全有效，操作
简便，止血效果可靠。
关键词：经皮缝合装置；压迫止血；冠状动脉造影；冠状动脉介人治疗：并发症
中图分类号：R654．3，R541．4文献标识码：A文章编号：1007—9688(2005)03—0156—04

1heclinicalapplicationofPercloseinpercutaneouscoronaryintervention

HouYuqing，ZhouZhongjiang，HuangZheng，GuoZhigang，JiaManyin
DepartmentofCardiology，NanFangHospital，theGuangdongprovincialSouthernMedical

University，Guangzhou510515，China
Abstract：0bjecfivesToassessthevalidityeficacyandclinicalapplicationofasuture．mediatedclosure
device(Percloser)comparedwithstandardmanualcompressioninpatientsafterpercutaneouscoronaryinterventions．
Themajorobservationendpointsincludedtheincidenceofvaseularcomplicationsandthetimetoambulation
aftertheprocedures．MethodsFivehundredandfourconsecutivepatientsunderwentpereutaneouscoronary
interventionwererandomlytreatedwithstandardmanualcompression(n：254)andsuture—mediatedpercutaneous
closureofantegradefemoralaccesssitebyPercloser(n=250)incardiaccatheterizationsprocedures．Suture．
mediatedclosureorinanualcompressionwereproceduredindependentoftheanticoagulationlevelaftercardiac

catheterizationprocedures．Thetimetoachievehemostasisandthetimetoambulationwascompared
，andthe
incidenceofcomplicationswasevaluatedtoo．ResultsAsignifcantreductioninthetimetoachievehemostasis

wasobserved(6±0．4vs25+_5．6minutes，P<O．001)inpercloserclosuregroupandstandardcompressiongroup
respectively．Thetimetoambulationwasalsolessened(4±1．2vs26+_3．8hoursP<0．001)inthetwogroupsandthis
seemedtobesignific