我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

壳聚糖对结构性心脏病股动脉穿刺压迫止血的协助作用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第1期
页码:
84-87
栏目:
临床研究
出版日期:
2012-02-25

文章信息/Info

Title:
Chitosan dressings achieve better femoral hemostasis after percutaneous procedures in patients with structural heart disease
作者:
张端珍; 朱鲜阳; 王 勃; 陈火元; 崔春生
(沈阳军区总医院先心病内科，辽宁 沈阳 110016)
Author(s):
ZHANG Duan-zhen;  ZHU Xian-yang;  WANG Bo;  CHEN Huo-yuan;  CUI Chun-sheng
(Department of Congenital Heart Disease, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China)
关键词:
止血; 动脉; 壳聚糖; 心脏病; 结构性
Keywords:
hemostasis;  artery;  chitosan;  structural heart disease
分类号:
R818.052.4；R543.5
DOI:
-
文献标识码:
A
摘要:
目的:探讨结构性心脏病患者股动脉穿刺后采用壳聚糖止血敷料协助压迫止血的效果及其相关因素。方法： 将需要行股动脉穿刺实施介入操作的结构性心脏病患者随机分成试验组和对照组2组，每组100例，心导管术时均使用6F或7F动脉鞘。术后分别采用壳聚糖止血敷料加压迫止血和传统压迫止血方式进行止血，记录压迫止血时间。试验组加压包扎4 h后患者活动下肢，对照组加压包扎6 h，平卧24 h，然后下床活动，记录出血并发症。结果： 试验组和对照组压迫止血时间分别为(4.0±1.5) min和(7.6±2.5) min（P<0.05），总体出血并发症分别为3%和11%（P<0.05）。试验组仅有3例出现渗血，而对照组分别出现3例渗血，4例出血和4例血肿。多元回归分析显示，在对照组中，年龄、体质量指数、血压、血小板计数和凝血酶原时间国际标准化比值对压迫止血时间无明显影响，而试验组压迫时间与血压水平呈正相关。结论： 壳聚糖止血敷料可有效缩短股动脉穿刺后压迫时间，并减少出血并发症。
Abstract:
AIM:To evaluate the efficacy and safety of chitosan dressings used for femoral hemostasis as an adjunct to manual compression in patients with structural heart disease undergoing cardiac catheterization. METHODS: Two hundred patients with structural heart disease undergoing cardiac catheterization were 1∶1 randomized for manual compression using regular or chitosan dressings. All patients were catheterized with a 6 Fr or 7 Fr sheath. Time to achieve hemostasis and incidence of minor and major bleeding were compared between groups. RESULTS: Time to achieve hemostasis was (4.0±1.5) and (7.6±2.5) min and the incidence of minor and major bleeding was 3% and 11%, respectively, in chitosan and regular dressings groups (P<0.05). Errhysis developed in 3%, and 3% of patients, respectively, in chitosan and regular dressings groups, but hematoma (n=4) and bleeding (n=4) were only observed in regular dressings group. Multiple regression models showed that the time to hemostasis was not associated with age, body mass index, blood pressure, blood platelet count and international normalized ratio in regular dressings group but was positively associated with mean blood pressure in chitosan dressings group. CONCLUSIONS: Compared with regular dressings, chitosan dressings significantly decrease the time to achieve hemostasis and lower the total incidence of hemorrhage.

参考文献/References

[1]方玉强,张 晔,曾春雨.桡动脉径路冠状动脉和外周血管介入诊疗的现状与未来[J].岭南心血管病杂志， 2011,17(1)：7-9.

[2]沈长银,石 蓓,许官学,等.尺动脉路径行冠状动脉造影及支架术35例体会[J].遵义医学院学报,2010,33(3)：234-235.

[3]石荣书,王福容,蒋国军.股动脉穿刺插管术后局部压迫止血的处理[J].中国医师进修杂志,2008,31(1):5-7.

[4]杨 剑,杨丽芳,杨秀玲,等.壳聚糖止血敷料用于经股动脉穿刺先天性心脏病[J].中国心血管杂志,2010,15(6):457-459.

[5]Arnaud F,Teranishi K,Tomori T,et al.Comparison of 10 hemostatic dressings in a groin puncture model in swine[J].J Vasc Surg,2009,50(3):632-639.

[6]Clay JG,Grayson JK,Zierold D.Comparative testing of new hemostatic agents in a swine model of extremity arterial and venous hemorrhage[J].Mil Med,2010, 175(4):280-284.

[7]Gegel BT,Burgert JM,Lockhart C,et al.Effects of Celox and TraumaDEX on hemorrhage control in a porcine model[J].AANA J,2010,78(2):115-120.

[8]Sohn VY,Eckert MJ, Martin MJ, et al. Efficacy of three topical hemostatic agents applied by medics in a lethal groin injury model[J].J Surg Res,2009,154(2):258-261.

[9]罗林杰,董少红,梁 旭,等.冠脉介入术后Angioseal血管缝合与压迫止血的对比研究[J].中国实用内科杂志,2004, 24(1):17-18.

[10]罗建方，黄文晖,刘 媛,等.血管缝合器在经皮行主动脉腔内修复术应用中的早期经验[J].中国介入心脏病学杂志,2010, 18(3):135-137.

[11]Arbel J,Rozenbaum E,Reges O,et al.USage of chitosan for Femoral (USF) haemostasis after percutaneous procedures:a comparative open label study[J].EuroIntervention,2011,6(9):1104-1109.

[12]Millner RW,Lockhart AS,Marr R,et al. Omni-Stat(Chitosan) arrests bleeding in heparinised subjects in vivo:an experimental study in a model of major peripheral vascular injury[J].Eur J Cardiothorac Surg,2011,39(6):952-954.

[13]Pusateri AE,McCarthy SJ,Gregory KW,et al.Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine[J].J Trauma,2003,54(1):177-182.

备注/Memo

备注/Memo:
收稿日期：2011-06-13.通讯作者：朱鲜阳，主任医师，主要从事结构性心脏病影像诊断和介入治疗研究 Email：xyangz@yahoo.com.cn 作者简介：张端珍，主治医师，博士 Email：meichengzhang123@163.com
更新日期/Last Update: 2012-02-14