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[目的]评价经股动脉PCI术后应用Perclose ProGlide(Abbott,USA)血管缝合器止血的安全性和可靠性,分析常见并发症及防范措施。[方法]对2007年2月—2011年1月第三军医大学新桥医院3 109例患者经股动脉PCI术后应用Perclose ProGlide血管缝合器止血的效果进行回顾性总结,分析院内并发症和失败原因,观察近期并发症。[结果]止血成功率95.6%(2 973/3 109),止血时间(2.9±0.8)min,术后制动时间(4.3±1.5)h,术后平均住院时间(4.5±1.2)d。院内整体并发症发生率1.6%(51/3 109),包括血肿19例,渗血16例,局部感染10例,假性动脉瘤3例,股动脉夹层2例,腹膜后血肿1例。其中与缝合器止血相关并发症1.2%。截至2012年3月,术后平均随访(12±2)个月,随访率66.7%(2 013/3 109),随访并发症发生率0.1%(3/2 013),其中包括2例迟发性股动脉夹层,1例股动脉晚期血栓。[结论]PCI术后应用Perclose ProGlide血管缝合器止血是一种安全、可靠的止血方法,值得进一步推广。
[Objective] To evaluate the safety and reliability of percutaneous occlusion of Perclose ProGlide (Abbott, USA) after PCI in femoral artery and to analyze common complications and preventive measures. [Methods] From March 2007 to January 2011, 3 109 patients in Xinqiao Hospital of Third Military Medical University were retrospectively analyzed with Perclose ProGlide suture closure device after PCI to analyze the complications and failure in hospital Cause, observe the recent complications. [Results] The hemostatic success rate was 95.6% (2 973/3 109), the bleeding time was 2.9 ± 0.8 min, the postoperative braking time was 4.3 ± 1.5 h and the postoperative average hospitalization time was 4.5 ± 1.2 d. The hospital overall complication rate was 1.6% (51/3 109), including 19 cases of hematoma, 16 cases of bleeding, 10 cases of local infection, 3 cases of pseudoaneurysm, 2 cases of femoral artery dissection and 1 case of retroperitoneal hematoma. Among them, complications associated with hemostasis of stapler were 1.2%. As of March 2012, the average postoperative follow-up was (12 ± 2) months with a follow-up rate of 66.7% (2 013/3 109) and a follow-up complication rate of 0.1% (3/2 013), including 2 late-onset Sexual femoral artery dissection, 1 case of advanced femoral artery thrombosis. [Conclusion] It is safe and reliable to use Perclose ProGlide vascular stapler to stop bleeding after PCI, which is worth further promotion.