2024 年第 6 期 第 0 卷

壳聚糖止血海绵联合螺旋桡动脉压迫器在经桡动脉冠状动脉介入术后的止血效果研究

Study on the hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor after transradial percutaneous coronary intervention

作者：余龙辉1宋梦丽1陈丽燕1谭文亮1蔡露1熊红英1涂伟玲1李林锋2康信军3

英文作者：Yu Longhui1 Song Mengli1 Chen Liyan1 Tan Wenliang1 Cai Lu1 Xiong Hongying1 Tu Weiling1 Li Linfeng2 Kang Xinjun3

单位：1江西省人民医院(南昌医学院第一附属医院）心血管内科，南昌330000；2南昌大学江西医学院，南昌330000；3江西省吉安市万安县人民医院心血管内科，吉安343800

英文单位：1Department of Cardiovascular Medicine Jiangxi Provincial People′s Hospital the First Affiliated Hospital of Nanchang Medical College Nanchang 330000 China; 2Nanchang University Jiangxi Medical College Nanchang 330000 China; 3Department of Cardiovascular Medicine Wan′an County People′s Hospital of Ji′an City Jiangxi Province Ji′an 343800 China

关键词：壳聚糖止血海绵；桡动脉；冠状动脉介入治疗；血管并发症

英文关键词：Chitosanhemostaticsponge;Radialartery;Coronaryintervention;Vascularcomplications

• 摘要：

• 目的 探讨壳聚糖止血海绵联合螺旋桡动脉压迫器在经桡动脉冠状动脉介入（TRI）术后的止血效果。方法 选取2021年4月至2022年7月在江西省人民医院心血管内科四区经桡动脉途径行冠状动脉造影或冠状动脉粥样硬化性心脏病介入治疗的患者295例，采用随机数字表法分为螺旋桡动脉压迫器组（A组，99例）、壳聚糖止血海绵组（B组，98例）及壳聚糖止血海绵联合螺旋桡动脉压迫器组（C组，98例），3组采用对应方法止血。观察记录3组术后桡动脉血管并发症及患者舒适度情况。结果 A组、B组及C组术后出血发生率分别为13.1%（13/99）、5.1%（5/98）、3.1%（3/98），术后出血、瘀斑、肢端肿胀发生率3组间差异均有统计学意义（均P<0.05），组间两两比较A组高于C组（均P<0.05）。术后桡骨血肿发生率A组高于C组（P=0.008）。所有患者均未发生术侧严重肢端肿胀及其他严重并发症。C组患者舒适度优于A组（P=0.004）。结论 壳聚糖止血海绵联合螺旋桡动脉压迫器在TRI术后总体止血效果优于单独使用螺旋桡动脉压迫器和壳聚糖止血海绵，可减少术后血管并发症发生率，提高患者舒适度，是一种操作简单、舒适度高、并发症少、安全可靠的止血方法。

• Objective To explore the hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor after transradial percutaneous coronary intervention(TRI). Methods From April 2021 to July 2022, 295 patients who underwent coronary angiography or interventional therapy for coronary atherosclerotic heart disease in the fourth district of the Department of Cardiovascular Medicine, Jiangxi Provincial People′s Hospital were selected. The patients were randomly divided into spiral radial artery compressor group (group A, 99 cases), chitosan hemostatic sponge group (group B, 98 cases), and chitosan hemostatic sponge combined with spiral radial artery compressor group (group C, 98 cases). The three groups were treated with corresponding methods to stop bleeding. The postoperative radial artery complications and patient comfort were observed and recorded in the three groups. Results The incidence rates of postoperative bleeding in group A, group B, and group C were 13.1%(13/99), 5.1%(5/98), and 3.1%(3/98), respectively, and there were significant differences in the incidence of postoperative bleeding, ecchymosis and acral swelling among the three groups (all P<0.05). Group A was higher than group C in pairwise comparison(P<0.05). The incidence of postoperative radial hematoma in group A was higher than that in group C (P=0.008). No severe limb swelling and other serious complications occurred in all patients. The comfort level of patients in group C was better than that in group A (P=0.004). Conclusion The overall hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor is better than that of spiral radial artery compressor and chitosan hemostatic sponge alone after TRI. It can reduce the incidence of postoperative vascular complications and improve the comfort of patients. It is a simple operation, high comfort, less complications, safe and reliable method of dressing hemostasis.