经桡动脉穿刺行冠状动脉造影术后绷带包扎与止血器的止血效果比较

吴世英 刘建红 高亚丽

摘 要 目的：比較经桡动脉穿刺行冠状动脉造影术后绷带包扎与止血器的止血效果。方法：收集2016年8月至2017年8月行经桡动脉穿刺行冠状动脉造影术患者40例，随机采用止血器止血（观察组）20例和绷带包扎止血（对照组）20例，观察两组止血效果、止血时间、止血期间压迫侧拇指血氧饱和度（SpO2）监测、止血期间不良反应发生情况以及止血4 h的舒适情况。结果：两组患者止血成功率、手部及前壁肿胀发生率及压迫侧静脉回流障碍发生率差异无统计学意义（P>0.05），止血期间拇指SpO2水平差异无统计学意义（P>0.05）。观察组止血时间为（5.46±0.93）h，低于对照组的（9.08±1.64）h（P<0.05）。观察组止血4 h患者自我感觉包扎太紧、肢体麻木/肿胀难受、活动受限率低于对照组（P<0.05）。结论：经桡动脉穿刺行冠状动脉造影术后使用止血器止血效果明确，止血时间短，不良反应少，患者舒适度高，值得临床推荐。

关键词 冠状动脉性心脏病；冠状动脉造影术；止血效果

中图分类号：R64 文献标志码：A 文章编号：1006-1533（2018）16-0026-03

Comparison of hemostatic effect between bandage dressing and hemostatic device after coronary angiography by radial artery puncture

WU Shiying1， LIU Jianhong2， GAO Yali2

（1.Static Distribution Center， 2.Hemodialysis Room of Peoples Hospital of Yichun， Jiangxi 336000， China）

ABSTRACT Objective： To compare the hemostatic effect of bandage dressing and hemostatic device after coronary artery angiography through radial artery puncture. Methods： From August 2016 to August 2017， 40 patients who underwent coronary angiography via radial artery puncture were collected， and randomly hemostatic devices were used to stop bleeding（an observation group with 20 cases） and bandage dressing was used to stop bleeding（a control group with 20 cases）. The hemostatic effect， hemostatic time， blood oxygen saturation（SpO2） monitoring during hemostasis， occurrence of adverse reactions during hemostasis and hemostatic 4 h comfortable situation were observed. Results： There was no significant difference in the success rate of hemostasis， the incidence of hand and anterior wall swelling， and the incidence of oppression of lateral venous return in the patients of the both groups（P>0.05）， and there was no statistically significant difference in thumb SpO2 during hemostasis（P>0.05）. The duration of hemostasis in the observation group was （5.46±0.93） hours， which was lower than that in the control group （9.08±1.64） hours（P<0.05）. Patients in the observation group who had hemostasis for 4 h felt that the selfdressing was too tight， limb numbness/swelling was uncomfortable， and the activity restriction rate were lower than those in the control group（P<0.05）. Conclusion： After coronary angiography with radial artery puncture， the hemostatic effect of hemostatic device is clear， the hemostatic time is short， the adverse reaction is less， and the patient is comfortable， which is worthy of clinical recommendation.

KEY WORDS coronary heart disease； coronary angiography； hemostatic effect

临床研究显示，经桡动脉穿刺行冠状动脉造影术损伤小、周围血管并发症少，较经股动脉穿刺临床优势更为明显，但术后止血效果仍对患者预后有一定影响[1]。因此，研究止血效果更好的止血手段不仅有利于提高手术预后，也是提升护理服务质量的重要举措。本研究对绷带包扎与止血器两种止血手段在经桡动脉穿刺行冠状动脉造影术后止血中的应用效果进行比较，现报道如下。

1 资料与方法

1.1 一般资料

收集2016年8月至2017年8月宜春市人民医院接诊的行经桡动脉穿刺行冠状动脉造影术患者40例，均为Allen试验阳性。按照随机数字表法将患者分为观察组和对照组各20例。观察组采用止血器止血，其中男性14例，女性6例，年龄40～72岁，平均（54.64±7.33）岁，伴有糖尿病7例，高血压13例。对照……