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目的 评价在肝素联合强效抗血小板制剂GPⅡb Ⅲa受体拮抗剂应用的情况下 ,经皮穿刺冠状动脉介入治疗 (PCI)术后使用Angio SealTM的效果和患者的满意度。方法 本组 16 1例患者接受肝素、GPⅡb Ⅲa受体拮抗剂和常规PCI治疗 ,其中术后应用Angio SealTM(A组 ) 10 5例 ,Femostop(B组 ) 5 6例。观察两组术后止血时间、早期行走时间和血管并发症及电话随访出院后 4 8h患者的满意度 ,并进行统计学分析。结果 Angio SealTM应用成功率为 98.1%。两组术后止血时间分别是 (1.8± 2 .2 )min和 (12 9± 5 1)min (P <0 .0 0 0 1) ;术后早期开始行走时间分别为(6 .4± 2 .3)h和 (15 .2± 4 .8)h(P <0 .0 0 0 1)。A组出现 2例血肿 ,均保守治疗 ;B组分别有 3例血肿 ,2例假性动脉瘤和 1例动静脉瘘 ,其中 3例送外科手术 ;两组总血管并发症的发生率分别为 1.9%与 10 .7% (P <0 .0 5 )。术后住院时间分别为 (2 8.2± 10 .4 )h和 (5 8.4± 10 .2 )h(P <0 .0 0 0 1)。出院后 4 8h随访满意度两组分别为 93.3%和 6 0 .7% (P<0 .0 0 1)。结论 在需要强效抗凝的情况下 ,PCI术后应用Angio SealTM在即刻止血、早期行走和缩短住院时间方面均优于传统压迫方法 ,尤其是能显著降低血管并发症的发生率和提高患者的满意度。
Objective To evaluate the efficacy and safety of Angio SealTM after percutaneous transluminal coronary intervention (PCI) in the presence of heparin and potent antiplatelet agent GPⅡb Ⅲa receptor antagonist. Methods One hundred and sixteen patients in our study were treated with heparin, GPⅡb Ⅲa receptor antagonist and conventional PCI. There were 105 cases of Angio SealTM (group A) and 56 cases of Femostop (group B) after operation. The postoperative hemostatic time, early walking time and vascular complications were observed and the satisfaction of the patients at 48 hours after telephone follow-up were observed and statistically analyzed. Results Angio SealTM application success rate was 98.1%. The postoperative hemostatic time of the two groups were (1.8 ± 2. 2) min and (12 9 ± 5 1) min respectively (P0.001) .3) h and (15 .2 ± 4 .8) h (P <0.00001). There were 2 hematomas in group A, all of which were conservatively treated. In group B, there were 3 hematomas, 2 pseudoaneurysms and 1 arteriovenous fistula, respectively. Three of them were surgically surgically treated. The incidences of total vascular complications were 1.9 % And 10.7% (P <0.05). The postoperative hospital stay was (2 8.2 ± 10. 4) h and (5 8.4 ± 10 .2) h (P <0. 0 0 0 1), respectively. The 48-hour follow-up satisfaction after discharge from the hospital was 93.3% and 60.7%, respectively (P0.01). Conclusions In the case of intensive anticoagulation, the application of Angio SealTM after PCI is superior to traditional compression methods in immediate hemostasis, early walking and shorter hospital stay. In particular, it can significantly reduce the incidence of vascular complications and improve the patient’s Satisfaction.