冠状动脉介入术后腹膜后血肿的危险因素研究

目的探讨冠状动脉介入术(PCI)后腹膜后血肿(RPH)的发生率、临床特征和危险因素。方法对北京安贞医院心内科2000-01—2005-09共3729例经股动脉穿刺进行PCI术的病例进行回顾性分析,其中并发RPH的21例设为观察组,选择另外30例未发生RPH的病例设为对照组。采用单因素和多因素分析RPH发生的危险因素。结果RPH的发生率为0·6%。RPH最常见的临床特征为贫血(100%),其余还包括低血压(95%)、出汗(57%)、腹股沟痛(48%)、下腹痛(38%)和背痛(38%)。RPH的独立预测因素有3个:女性(OR=5·23,P<0·0001)、体表面积(BSA)<1·53m2(OR=7·11,P=0·005)和高部位股动脉穿刺(OR=5·42,P=0·001)。结论女性、低BSA和高部位股动脉穿刺是RPH发生的独立预测因素。

Risk factors for the development of retroperitoneal hematoma after percutaneous coronary intervention

Objective We sought to determine the incidence,clinical features,and risk factors for retroperitoneal hematoma(RPH)after percutaneous coronary intervention(PCI).Methods A retrospective analysis yielded 21 cases of RPH out of 3,729 consecutive patients undergoing PCI between January 2000 and September 2005 in Anzhen hospital.Cases were compared with a randomly selected sample of 30 control subjects without RPH.Predictors were studied using univariate and multivariate analysis.Results The incidence of RPH was 0.6%.Anemia(100%)was a most universal feature.Features of RPH included hypotension(95%),diaphoresis(57%),groin pain(48%),abdominal pain(38%)and back pain(38%).The following variables were found to be independent predictors of RPH:female gender(odds ratio OR=5.23,P<0.0001),low body surface area(BSA <1.53 m~2;OR=7.11,P=0.005),and higher femoral artery puncture(OR=5.42,P=0.001).Conclusion Female gender,low BSA,and higher femoral artery puncture are significant risk factors for RPH.