5-冠脉造影术后常规处理.pptxVIP免费

冠状动脉造影术后处理北京安贞医院心内科吴小凡第一页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital成功的冠状动脉造影检查取决于标准的手术过程和准确的术后处理：拔除鞘管止血方式术后监测并发症处理第二页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital拔除鞘管和压迫止血拔管时机绝大多数术后即刻拔管术中肝素>5000单位，ACT<180s可拔管第三页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital拔除鞘管和压迫止血准备药品：利多卡因、阿托品器材：方盘、注射器、无菌手套、纱布、弹力绷带第四页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital拔除鞘管和压迫止血部位：左手食指、中指、无名指并排垂直放置在穿刺点近心端5~10mm时间：5~15分钟程度：“度〞(足背动脉搏动/下肢紫绀)弹力绷带加压包扎6小时第五页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital止血人工压迫止血器械压迫止血Femostop血管闭合器PercloseAngiosealVasoseal第六页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital第七页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospital血管闭合器PercloseAngiosealVasoseal第八页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospitalMarketshare第九页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospitalAccessSiteManagement2003estimatedusePatchesDuettVasosealRadialPercloseAngiosealCompression第十页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospitalJAMA,January21,2004,Vol291,No.31.141.481.191.611.2100.20.40.60.811.21.41.61.8HaematomaBleedingPseudoaneurysmSurgeryTransfusionArterialPunctureClosingDevicesComparedwithStandardManualCompressionafterCardiacCatheterizationIncreaseriskwithdevicesRRMeta-analysisof30trialswith4,000patientsand7devices第十一页，共一百零一页。RoutinemanagementaftercoronaryangiographyBeijingAnzhenHospitalComplicationsDevicesvsCompression0.50%0.67%0.78%0.20%0.30%0.21%0.08%0.03%0.06%0.10%0.00%0.0...