标题：经皮穿刺预缝合技术在体外膜肺氧合快速建立血管通路中的应用

      作者：冯钢，许志锋，韩振，吴永前，任明明，欧阳春，叶小强，黄磊，温远祥    (北京大学深圳医院心血管外科，广东 深圳 518036)

      卷次： 2018年29卷10期

      【摘要】 目的 探讨经皮穿刺预缝合技术在体外膜肺氧合(ECMO)快速建立血管通路中的有效性及安全性。方法 回顾分析北京大学深圳医院2015年1月至2017年7月经皮穿刺置管并应用Proglide血管缝合器行动脉预缝合建立血管通路行ECMO支持的 12例患者的临床资料，观察经皮穿刺置管成功率、置管时间、切口出血、切口感染、远端肢体缺血情况以及拔管后穿刺口出血情况。结果 经皮穿刺股动静脉置管成功率为100%，平均置管时间为(8.2±2.7) min，切口出血发生率为0 (0/12)，切口感染发生率为0 (0/12)，下肢缺血发生率为8.3% (1/12)，拔管后穿刺口出血率为0 (0/12)。结论 经皮穿刺可以快速建立血管通路，可以有效避免切口出血、感染以及避免远端肢体缺血，动脉预缝合技术可以保证拔管后穿刺口的安全止血，经皮穿刺预缝合技术在体外膜肺氧合快速建立血管通路应用安全有效。
      【关键词】 经皮穿刺置管；血管预缝合；血管通路建立；体外膜肺氧合
      【中图分类号】 R654.3 【文献标识码】 A 【文章编号】 1003—6350（2018）10—1455—03

Curative effect on percutaneous pre-suture technique in rapid establishment of vascular access forextracorporeal membrane oxygenation.
FENG Gang, XU Zhi-feng, HAN Zhen, WU Yong-qian, REN Ming-ming,OUYANG Chun, YE Xiao-qiang, HUANG Lei, WEN Yuan-xiang. Department of Cardiovascular Surgery, Shenzhen Hospitalof Peking University, Shenzhen 518036, Guangdong, CHINA
【Abstract】 Objective To evaluate the efficacy and safety of percutaneous pre-suture technique in the rapid es-tablishment of vascular access for extracorporeal membrane oxygenation (ECMO). Methods The clinical data of 12 pa-tients supported by ECMO whose vascular access were established by percutaneous technique and pre-suture by Pro-Glide vessel suture instrument from January 2015 to July 2017 in Shenzhen Hospital of Peking University were analyzedretrospectively. The rate of successful catheterization, the consuming time of catheterization, the rate of incision bleed-ing, the incidence of incision infection, the situation of distal limb ischemia and the bleeding rate after extubation wereobserved. Results The rate of success catheterization was 100% and the average catheter consuming time was (8.2±2.7) minutes. The rate of incision bleeding was 0 (0/12), and wound infection was 0 (0/12). The incidence of ischemia indistal limb was 8.3% (1/12), and puncture bleeding after extubation was 0 (0/12). Conclusion Vascular access can berapidly established by using the technique of percutaneous puncture, which can effectively prevent bleeding and infec-tion of the surgical incision, and avoid ischemia in the distal limb. The technique of arterial pre-suture can ensure thesafe hemostasis of the puncture port after extubation. The percutaneous pre-suture technique is safe and effective in therapid establishment of vascular access for ECMO.
      【Key words】 Percutaneous catheterization; Vascular pre-suture; Establishment of vascular access; Extracorporealmembrane oxygenation (ECMO)·临床经验·doi:10.3969/j.issn.1003-6350.2018.10.039基金项目：广东省深圳市科技计划项目(编号：JCYJ20150403091443327)