林曉靜 李廣平 許綱 尹力 袁如玉 鄭心田 陳欣 徐延敏 天津醫科大學第二醫院心臟科 （天津，300211，中國）
摘要 目的 評價冠狀動脉介入治療後closure wire血管封堵器與傳統手工壓迫法止血的療效。方法 經皮穿刺股動脉途徑行冠脉造影術及冠脉介入治療術患者104例，其中傳統手工壓迫組56例，closure wire封堵器組48例。觀察即刻止血效果，患者滿意度，48小時內皮下淤血最大面積，術後～10天相關血管幷發症的發生率。結果 封堵器組即刻止血效果佳，達97.9%，所需臥床時間顯著縮短，滿意程度高。兩組皮下淤血，血腫，迷走神經反射，假性動脉瘤發生率分別爲10.4% vs 16.0%；0.02% vs 0.07%；0% vs 0.09%；0% vs 0.02%，皮膚淤血面積爲(32.2±14.2)cm 2 vs (80.0±25.6)cm2。傳統壓迫法1例因腹膜後血腫而急需輸血。結論 closure wire封堵器在經股動脉行冠脉造影及冠脉成型術中是安全有效的，相關血管幷發症有减少的趨勢，特別是嚴重的出血幷發症。
關鍵詞 closure wire封堵器；動脉幷發症；經皮冠脉介入
Evalution of the clinical application and efficacy of Boomerang closure wire device compared with traditional compression hemostesis
Lin Xiaojing,Li Guangping,Xu Gang ,Yin Li,Yuan Ruyu,Zheng Xintian,Chen Xin,Xu Yanmin
Abstract Background To assess the safety and efficacy of Boomerang closure wire compared with traditional manual compression in patients underwent coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods One hundred and four cases who underwent transfemoral CAG or PCI were included in this study ,56 cases were treated with traditional compression of hemostasis,48 cases treated with Boomerang closure wire ,the immedicate hemostasia time ,postoperative complication, the max area of subcutaneous gore in 48 h were compared. Results The efficacy of immedicated hemostasia time in closure wire group is better, efficacy is 97.9%, low limb immobilization time is much shorter than tradition group, the occurrence of subcutaneous gore ,femoral hematoma, vagal reflect ,pseudoaneurysm in two group respectively were 10.4% vs 16.0%; 0.02% vs 0.07%; 0.00% vs 0.09%; 0.00% vs 0.07%, while the max area of subcutaneous gore were 22.2±4.2 vs 80.0±25.6 cm., no patients experienced major complications in closure wire group, but one case experienced blood transfusion to retroperitoneal bleed. Conclusions Closure wire is safe and effective in patients undergoing CAG or PCI using the transfemorl approach, there is an decreased trends in related artery complication, especsically major complication.
Keywords closure wire device;artery complication;percutaneous coronary intervention
