两种血管闭合器在经股动脉途径冠状动脉介入治疗中的疗效比较

摘要

目的 比较Angio-Seal血管闭合器和Starclose闭合器在经股动脉途径冠状动脉介入治疗中封堵穿刺点的即刻成功率、术后24小时及术后1周与穿刺有关并发症.方法 选取2008年1月至2010年12月经股动脉途径介入治疗的冠心病患者277例,其中135例予Angio-Seal血管闭合器封堵穿刺点,142例予Starclose血管闭合器封堵穿刺点,比较二者术后即刻封堵成功率、术后24小时及1周内穿刺点出血、血肿、假性动脉瘤、局部皮肤破溃感染、动脉夹层、迷走反射等与穿刺有关并发症.结果 两组患者术后即刻手术成功率、止血时间及制动时间差异无统计学意义(P＞0.05),术后24小时Starclose组与穿刺有关并发症6例,Angio-Seal组14例(P＜0.05).术后1周Starclose组与穿刺有关并发症8例,Angio-Seal组18例(P＜0.05).结论 Starclose血管闭合器封堵股动脉穿刺点较Angio-Seal闭合器更安全可靠,值得在临床应用推广.%Objective The moment successful ratio and puncture syndrome after 24 hours and one week were compared on femoral artery closure by system of Starclose and Angio-Seal after percutaneous coronary intervention. Methods Two hundred and seventy-seven patients wih coronary heart disease were randomly divided into Starclose group( n = 142) and Angio-Seal group ( n = 135), which were closed by Angio-Seal closure devices or Starclose closure devices after femoral artery percutaneous coronary intervention. The time to hemaostasis, time to cessation, moment successful ratio and puncture syndrome after 24 hours and one week were compared between two groups. Results There was no significant difference between two groups in the time to hemaostasis, time to cessation, moment successful ratio after 24 hours and one week. In Starclose group there were 6 cases with puncture syndrome after 24 hours and 8 cases with puncture syndrome after one week, in Angio-Seal group there were 14 cases with puncture syndrome after 24 hours and 18 cases with puncture syndrome after one week( P <0. 05). Conclnsion The femoral artery closure device of Starclose is more safe and reliable than closure device of Angio-Seal.