【摘要】 目的 观察冠状动脉介入术后Perclose缝合装置对老年病人的安全性和有效性。方法 选取我科2006年1月~2007年7月收治的587例应用外周血管缝合器病人,比较老年病人和非老年病人的缝合成功率及并发症的发生率。结果 老年病人376例,成功364例,发生并发症12例;非老年病人211例,成功202例,发生并发症9例,两组比较差异无统计学意义(P>0.05)。结论 老年病人冠状动脉介入术后应用外周血管缝合器是安全有效的。
【关键词】 老年人;冠状动脉疾病;血管;外科缝合器
EVALUATION OF THE EFFECT OF PERCLOSE SUTUREMEDIATED CLOSURE DEVICE IN ELDERLY PATIENTS AFTER CORONARY INTERVENTION CHEN XIN, CHEN YUNDAI, LIU XIN, et al (Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China); [ABSTRACT] Objective To observe the safety and effectiveness of Perclose suturemediated closure device for elderly patients undergoing coronary intervention. Methods From January 2006 to July 2007, 587 patients who used Perclose device after coronary angioplasty were analyzed and compared the succes rate and complications between aged group (>60 years) and younger groop. Results Of 376 aged patients, 364 were succeeded, complications seen in 12; of 211 younger ones, 202 were succeeded, and complications seen in nine, no statistic difference was noted (P>0.05). Conclusion Perclose devise is safe and effective for the aged undergoing coronary intervention.
[KEY WORDS] The aged; Coronary artery disease; Blood vessel; Surgical stitching instrument
冠状动脉介入治疗术后,过去一般采用徒手压迫止血法使股动脉创口闭合,其中经皮冠状动脉介入治疗(PCI)病人是根据测其活化部分凝血激酶时间(APTT)或活化凝血时间(ACT)拔管,而术后一般需要平卧24 h甚至更长时间,容易造成外周血肿、夹层、外周血管血栓形成、假性动脉瘤等并发症,部分病人甚至出现肺栓塞等严重并发症[1]。而外周血管缝合器的应用,大大减少了病人的卧床时间,减轻了病人的痛苦,减少了冠状动脉介入术后外周血管并发症[2]。本文旨在评介老年人冠状动脉介入术后应用Perclose缝合装置的疗效,现报告如下。
1 资料和方法
1.1 对象与分组
选取我科2006年1月~2007年7月行冠状动脉操作(包括冠状动脉造影和PCI)后应用Perclose外周血管缝合器病人587例,其中肥胖病人88例(BMI≥30 kg/m2),有腰椎间盘突出症病史者76例,男性病人中有明确的前列腺增生病史者67例。将病人分为2组,老年组(年龄≥60岁)376例,非老年组(<60岁)211例。两组一般资料比较差异无显著性。见表1。
1.2 Perclose缝合装置的适应证
①用6f~7f鞘管经股动脉行介入操作的病人;②股动脉穿刺点在股总动脉主干,股浅和股深动脉分叉2 mm以上;③穿刺处股动脉血管内径光滑,局部无斑块;④
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