脑血管病介入治疗后动脉鞘管拔管时间与血管并发症

脑血管病介入治疗后动脉鞘管拔管时间与血

管并发症

【摘要】目的通过比较脑血管病介入治疗术后不同时间内拔除动脉鞘管对术后并发症的影响,旨在减少脑血管病介入治疗患者的术后血管并发症,为脑血管病介入治疗术后动脉鞘管拔管时间提供临床依据。方法根据病情、术后使用肝素情况将147例行脑血管病介入治疗的患者分别与于术后＜1 h拔除动脉鞘管47 例（A组）；术后留置4～6 h内拔除动脉鞘管49 例（B组）；术后留置7～24 h内拔除动脉鞘管51 例（C组）,比较三组患者术后并发症情况。结果 A组未出现术后血管并发症,B组发生术后血管并发症8 例, C组发生术后血管并发症12 例。结论脑血管病介入治疗术后,结合病情尽早拔除动脉鞘管,可以预防和减少血管并发症的发生。

【关键词】脑血管病介入治疗动脉鞘管拔管并发症护理

Abstract： Objective By comparing the effects of artery sheath catheter at different time on postoperative complications after interventional therapy of cerebrovascular disease, we aim to reduce the postoperative complications of interventional therapy of cerebrovascular disease and provide clinical reference on artery sheath catheter removal time. Methods According to patients' condition and administration

dosage of heprain, 147 patients subjected to interventional therapy were divided into three groups. In Group A of 47 patients, artery sheath catheter was removed immediately after interventional therapy, while in Group B of 49 patients, it was removed 4～6 h after interventional therapy, and in Group C of 51 patients, it was removed 7～24 h after interventional therapy. The incidence of postoperative complications in three groups was compared. Results No postoperative complication occurred in Group A, while in Group B, postoperative complications occurred in 8 cases (P<0.05), and in Group C, postoperative complications occurred in 12 cases (P<0.05). Conclusions After interventional therapy of cerebrovascular disease, immediate removal of artery sheath catheter could prevent and reduce the occurrence of postoperative complications.

Key words：interventional therapy of cerebrovascular disease;removal of artery sheath catheter; complication;nursing

脑血管病（Cerebrovascular Disease,CVD）发病率、致残率和死亡率很高,是威胁人类健康的三大主要疾病之一［1］。介入治疗脑血管病是目前脑血管病行之有效的治疗方法,该技术创伤小,恢复快,减

轻了患者的痛苦,提高了治疗的成功率。但介入治疗需要穿刺股动脉,易造成血管损伤,特别是术后留置动脉鞘管会加重对血管的损伤,导致穿刺部位出血及血肿、动-静脉瘘、假性动脉瘤、血栓形成、栓塞等血管并发症的发生。为探讨动脉鞘管拔管时间对脑血管病介入治疗术后血管并发症的影响,本研究选择2003年至2007年本院接受脑血管病介入治疗的147 例患者,根据患者病情及手术情况进行术后＜1 h 拔管,术后4～6 h 拔管以及术后7～24 h拔管的对比研究,旨在探讨脑血管病介入治疗术后拔管时间与术后血管并发症发生的关系,以降低术后血管并发症的发生率,为脑血管病介入治疗术后寻找适合的动脉鞘管拔管时间提供可靠的临床依据。

1 资料与方法

1.1 研究资料

本院行介入治疗的脑血管病患者147 例,术前血小板、凝血 4 项、肝肾功能等相关检查均正常, 使用6F动脉鞘管股动脉穿刺一次成功。将147 例按介入治疗术后拔除动脉鞘管时间不同分为A组（47 例）、B组（49 例）、C组（51 例）,分别为＜1 h拔除动脉鞘管、术后4～6 h内拔除以及术后7～24 h内拔除（表1）。各组年龄、性别、体重、病情及手术方法、手术时间、术中肝素用量比较,差异无显著性意义(P>0.05)。表 1 脑血管病介入患者不同拔管时间分组情况