摘要
目的:对经皮冠状动脉介入术(PCI)后桡动脉压迫式止血器减压及压迫时间的最佳界值进行临床试验,以对提升患者舒适度,降低术后血管并发症有所帮助。方法:选取在医院就诊的216例择期行冠心病介入诊疗术患者,采用数表法随机将其纳入对照组和观察组,每组108例。两组均采用桡动脉径路,使用同一型号桡动脉压迫式止血器;对照组首次减压时间自术后2 h开始,设定持续减压时间为1次/2 h,直至术后8 h无渗血后撤除压迫器;观察组首次减压时间稍提前为术后1.0~1.5 h,动态调节压力止血器减压及压迫时间,术后6 h完全拆除压力止血器。对两组患者术后采用数字评级量表(NRS)进行疼痛评分,并对NRS评分情况分布及研究过程中术肢出血、血肿等并发症情况进行评估。结果:在压迫止血期间观察组患者NRS评分为(2.63±0.60)分,对照组为(3.50±0.81)分,两组比较差异有统计学意义(t=4.271,P<0.05)。并发症方面比较,术后24 h期间血肿及再出血情况两组近似,无统计学差异,观察组患者皮肤青紫、末梢循环变差及张力性水泡发生率较对照组降低,差异具有统计学意义(x^2=6.271,x^2=7.014,x^2=2.398;P<0.05)。结论:PCI术后应用桡动脉压迫式止血器止血时,应视具体情况确定减压及压迫时间,为了减少术肢出血及血肿的风险,增进患者舒适程度,执行第一次减压为术后1.0~1.5 h,此后采取动态减压为宜,尽量避免压迫时间>6 h。
Objective: To implement clinical experiment for the optimal dividing value of decompression and compression time of compression hemostatic device of radial artery post percutaneous coronary intervention(PCI) so as to have helps for improving comfort level of patients and reducing postoperatively vascular complications. Methods: 216 patients who underwent interventional diagnosis and treatment of coronary heart disease were selected, and they were divided into control group(108 cases) and observation group(108 cases). Both two groups adopted radial artery path, and used same type of compression hemostatic device of radial artery. And the first decompression time of control group started at postoperative 2 h, and the sustained decompression time was set at 1 time/2 h until without errhysis at 8 h post operation to withdraw compression hemostatic device. And that of observation group started at postoperative 1.0-1.5 h, and the decompression and the compression time of compression hemostatic device were dynamically adjusted, and the device was completely withdrawn at postoperative 6 h. The numerical rating scale(NRS) was adopted to implement operative pain scores for patients of two groups, and the distribution of NRS scores condition and the complication conditions such as bleeding of surgical limb, hematoma, etc. in research process of two groups were further assessed. Results: In the period of compression hemostasis, the NRS scores of observation group was(2.63±0.06) scores and that of control group was(3.50±0.81)scores, and the difference of NRS scores between two groups was significant(t=4.271, P<0.05). On the aspect of comparison for complications, the hematoma and rebleeding of two groups were similar within 24 h post operation, and the differences of them between the two groups were no statistically significant. The incidences of skin cyanosis, poor peripheral circulation and tension blisters of observation group was significantly lower than those of control group(x^2=6.271,x^2=7.014, x^2=2.398, P<0.05), re
作者
王琨
王秀
王瑞枝
WANG Kun;WANG Xiu;WANG Rui-zhi(Department of Gynecology and Obstetrics,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)
出处
《中国医学装备》
2020年第4期39-42,共4页
China Medical Equipment
基金
内蒙古医科大学2019年度高等教育教学改革研究项目(NYJXGG2019059)“以创客理论为依托的手术室护理教学设计与实践”。
