主動脈腔內修復術雙Perclose ProGlide交叉縫合與傳統縫合穿刺點的療效比較_《中國修復重建外科雜志》

作者：

衛任 , 熊江 , 郭偉 , 劉小平 , 張宏鵬 , 賈鑫

解放軍總醫院血管外科（北京，100853）;

關鍵詞：

主動脈腔內修復術穿刺點修復雙Perclose ProGlide交叉縫合傳統縫合

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目的通過與傳統縫合比較，探討主動脈腔內修復術采用雙Perclose ProGlide交叉縫合修復20F或22F穿刺點的優缺點，為臨床穿刺點修復方法選擇提供參考。方法2007年6月－2011年5月，103例115側采用外徑為20F或22F輸送鞘行主動脈腔內修復術，其中采用雙Perclose ProGlide交叉縫合修復穿刺點57例64側（雙Perclose組），傳統縫合修復46例51側（傳統縫合組）。兩組患者年齡、性別、病程等一般資料比較，差異均無統計學意義（P gt; 0.05），具有可比性。結果雙Perclose組不同病種患者的手術時間、術中出血量、住院時間均明顯優于傳統縫合組（P lt; 0.05）。術后雙Perclose組5例（5側）、傳統縫合組2例（2側）出現不同程度腹股溝區皮下瘀血；雙Perclose組2例（2側）皮膚穿刺點處淋巴漏，傳統縫合組6例（8側）切口發生淋巴漏。雙Perclose組術后早期并發癥發生率為7.8%（5/64），傳統縫合組為15.7%（8/51），比較差異無統計學意義（χ2=1.76，P=0.19）。雙Perclose組技術成功率為96.9%（62/64），傳統縫合組為100%（51/51），差異無統計學意義（χ2=0.31，P=0.50）。兩組患者術后均獲隨訪，雙Perclose組隨訪時間2～19個月，平均15個月；傳統縫合組隨訪時間2～18個月，平均14個月。雙Perclose組1例（1側）術后3個月出現原穿刺點處假性動脈瘤，給予切開縫合；其余患者無縫合動脈狹窄、假性動脈瘤形成等中期并發癥發生。雙Perclose組中期并發癥發生率為1.6%（1/64），傳統縫合組為0，兩組比較差異無統計學意義（P=1.000）。結論與傳統縫合技術相比，雙Perclose ProGlide交叉縫合技術修復主動脈腔內修復術中20F或22F穿刺點療效相似，但在控制手術時間、術中出血量及住院時間方面具有明顯優勢。

引用本文： 衛任,熊江,郭偉,劉小平,張宏鵬,賈鑫. 主動脈腔內修復術雙Perclose ProGlide交叉縫合與傳統縫合穿刺點的療效比較. 中國修復重建外科雜志, 2012, 26(8): 968-971. doi: 復制

1.	Ramponi F, Yan TD, Vallely MP, et al. Total percutaneous cardiopulmonary bypass with Perclose ProGlide. Interact Cardiovasc Thorac Surg, 2011, 13(1): 86-88.
2.	張宏鵬, 郭偉, 劉小平, 等. 完全穿刺技術在腹主動脈瘤腔內修復術中的應用. 中華外科雜志, 2010, 48(24): 1855-1858.
3.	Grenon SM, Gagnon J, Hsiang YN, et al. Canadian experience with percutaneous endovascular aneurysm repair: short-term outcomes. Can J Surg, 2009, 52(5): E156-160.
4.	Lee WA, Brown MP, Nelson PR, et al. Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique). J Vasc Surg, 2007, 45(6): 1095-1101.
5.	Dosluoglu HH, Cherr GS, Harris LM, et al. Total percutaneous endovascular repair of abdominal aortic aneurysms using Perclose ProGlide closure devices. J Endovasc Ther, 2007, 14(2): 184-188.
6.	Starnes BW, Andersen CA, Ronsivalle JA, et al. Totally percutaneous aortic aneurysm repair: experience and prudence. J Vasc Surg, 2006, 43(2): 270-276.
7.	Georgiadis GS, Antoniou GA, Papaioakim M, et al. A meta-analysis of outcome after percutaneous endovascular aortic aneurysm repair using different size sheaths or endograft delivery systems. J Endovasc Ther, 2011, 18(4): 445-459.
8.	Quinn SF, Kim J. Percutaneous femoral closure following stent-graft placement: use of the Perclose device. Cardiovasc Intervent Radiol, 2004, 27(3): 231-236.
9.	Bent CL, Fotiadis N, Renfrew I, et al. Total percutaneous aortic repair: midterm outcomes. Cardiovasc Intervent Radiol, 2009, 32(3): 449-454.
10.	Jean-Baptiste E, Hassen-Khodja R, Haudebourg P, et al. Percutaneous closure devices for endovascular repair of infrarenal abdominal aortic aneurysms: a prospective, non-randomized comparative study. Eur J Vasc Endovasc Surg, 2008, 35(4): 422-428.
11.	Teh LG, Sieunarine K, van Schie G, et al. Use of the percutaneous vascular surgery device for closure of femoral access sites during endovascular aneurysm repair: lessons from our experience. Eur J Vasc Endovasc Surg, 2001, 22(5): 418-423.
12.	Lee WA, Brown MP, Nelson PR, et al. Midterm outcomes of femoral arteries after percutaneous endovascular aortic repair using the Preclose technique. J Vasc Surg, 2008, 47(5): 919-923.
13.	Al-Khatib WK, Zayed MA, Harris EJ, et al. Selective use of percutaneous endovascular aneurysm repair in women leads to fewer groin complications. Ann Vasc Surg, 2012, 26(4): 476-482.
14.	Bangalore S, Arora N, Resnic FS. Vascular closure device failure: frequency and implications: a propensity-matched analysis. Circ Cardiovasc Interv, 2009, 2(6): 549-556.
15.	Morasch MD, Kibbe MR, Evans ME, et al. Percutaneous repair of abdominal aortic aneurysm. J Vasc Surg, 2004, 40(1): 12-16.

1. Ramponi F, Yan TD, Vallely MP, et al. Total percutaneous cardiopulmonary bypass with Perclose ProGlide. Interact Cardiovasc Thorac Surg, 2011, 13(1): 86-88.
2. 張宏鵬, 郭偉, 劉小平, 等. 完全穿刺技術在腹主動脈瘤腔內修復術中的應用. 中華外科雜志, 2010, 48(24): 1855-1858.
3. Grenon SM, Gagnon J, Hsiang YN, et al. Canadian experience with percutaneous endovascular aneurysm repair: short-term outcomes. Can J Surg, 2009, 52(5): E156-160.
4. Lee WA, Brown MP, Nelson PR, et al. Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique). J Vasc Surg, 2007, 45(6): 1095-1101.
5. Dosluoglu HH, Cherr GS, Harris LM, et al. Total percutaneous endovascular repair of abdominal aortic aneurysms using Perclose ProGlide closure devices. J Endovasc Ther, 2007, 14(2): 184-188.
6. Starnes BW, Andersen CA, Ronsivalle JA, et al. Totally percutaneous aortic aneurysm repair: experience and prudence. J Vasc Surg, 2006, 43(2): 270-276.
7. Georgiadis GS, Antoniou GA, Papaioakim M, et al. A meta-analysis of outcome after percutaneous endovascular aortic aneurysm repair using different size sheaths or endograft delivery systems. J Endovasc Ther, 2011, 18(4): 445-459.
8. Quinn SF, Kim J. Percutaneous femoral closure following stent-graft placement: use of the Perclose device. Cardiovasc Intervent Radiol, 2004, 27(3): 231-236.
9. Bent CL, Fotiadis N, Renfrew I, et al. Total percutaneous aortic repair: midterm outcomes. Cardiovasc Intervent Radiol, 2009, 32(3): 449-454.
10. Jean-Baptiste E, Hassen-Khodja R, Haudebourg P, et al. Percutaneous closure devices for endovascular repair of infrarenal abdominal aortic aneurysms: a prospective, non-randomized comparative study. Eur J Vasc Endovasc Surg, 2008, 35(4): 422-428.
11. Teh LG, Sieunarine K, van Schie G, et al. Use of the percutaneous vascular surgery device for closure of femoral access sites during endovascular aneurysm repair: lessons from our experience. Eur J Vasc Endovasc Surg, 2001, 22(5): 418-423.
12. Lee WA, Brown MP, Nelson PR, et al. Midterm outcomes of femoral arteries after percutaneous endovascular aortic repair using the Preclose technique. J Vasc Surg, 2008, 47(5): 919-923.
13. Al-Khatib WK, Zayed MA, Harris EJ, et al. Selective use of percutaneous endovascular aneurysm repair in women leads to fewer groin complications. Ann Vasc Surg, 2012, 26(4): 476-482.
14. Bangalore S, Arora N, Resnic FS. Vascular closure device failure: frequency and implications: a propensity-matched analysis. Circ Cardiovasc Interv, 2009, 2(6): 549-556.
15. Morasch MD, Kibbe MR, Evans ME, et al. Percutaneous repair of abdominal aortic aneurysm. J Vasc Surg, 2004, 40(1): 12-16.

《中國修復重建外科雜志》

主動脈腔內修復術雙Perclose ProGlide交叉縫合與傳統縫合穿刺點的療效比較

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《中國修復重建外科雜志》

主動脈腔內修復術雙Perclose ProGlide交叉縫合 與傳統縫合穿刺點的療效比較

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主動脈腔內修復術雙Perclose ProGlide交叉縫合與傳統縫合穿刺點的療效比較

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