手外伤患者静脉输注不同药物穿刺点止血方法的研究  

Hemostasis of Puncture Sites after IV Infusion of Different Medications in Patients with Hand Injury

作　　者：陈淑琴[1] 赵崇梅[1] 张立新[1] 宋海燕[1] 张郑荣[1] 

机构地区：[1]解放军第401医院全军手外科中心,山东青岛266071

出　　处：《解放军护理杂志》2005年第5期1-3,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨手外伤患者静脉输注不同药物拔针后穿刺点有效的止血方法。方法396例手外伤患者按静脉输注药物不同分为普通药物(抗生素)组219例,抗凝药物(抗生素+抗凝药)组177例。再用随机方法分为普通Ⅰ组(70例)、普通Ⅱ组(68例)、普通Ⅲ组(81例)和抗凝Ⅰ组(56例)、抗凝Ⅱ组(62例)、抗凝Ⅲ组(59例)。Ⅰ组患者(包括普通Ⅰ组和抗凝Ⅰ组)在静脉输液完毕拔针后,穿刺点止血应用屈肘抬高手臂;Ⅱ组患者应用直肘抬高手臂;Ⅲ组患者由护士按压止血。观察3种止血方法在不同组间、不同时间的出血率。结果普通药物组应用屈肘抬高手臂3min,可达到与同组由护士按压止血3min同样的有效止血效果(P>0.05);抗凝药物组直肘抬高手臂4min可达到与同组由护士按压止血4min同样的有效止血效果(P>0.05)。结论手外伤患者静脉输液完毕拔针后,患手不能帮助按压穿刺点,根据静脉输注的药物不同,选择屈肘抬高手臂或直肘抬高手臂的止血方法,可达到有效的止血效果,节约了护士的时间,减轻了患者的痛苦。Objective To explore methods for effective hemostasis of puncture sites after IV infusion of different medications in patients with hand injury.Methods 396 patients with hand injury were divided into common drug group (n=219) and anticoagulant group (n=177). The two groups were further randomized into common drug group Ⅰ (n=70), common drug group Ⅱ(n=68), common drug group Ⅲ(n=81), anticoagulant groupⅠ(n=56),anticoagulant group Ⅱ(n=62), and anticoagulant group Ⅲ(n=59). After withdrawing the needle at the end of the infusion, hemostasis of the puncture sites were managed in 3 ways: elevation of the upper extremity with the elbow flexed,elevation of the upper extremity with the elbow extended, and pressing the puncture sites by a nurse. The blood-oozing rate was observed and recorded for each group at different time points.Results In common drug groups,elevation of the upper extremity with the elbow flexed for 3 minutes and pressing the puncture sites by a nurse for 3 minutes had the same hemostatic effect (P>0.05 ).In anticoagulant groups,elevation of the upper extremity with the elbow extended for 4 min had the same hemostatic effect as compared with pressing the puncture sites by a nurse for 4 min(P>0.05 ).Conclusion Pressing the puncture sites by the patient himself or herself is not recommended for hemostasis after IV infusion in patients with hand injury. Instead, the patient can elevate his/her upper extremity with the elbow flexed or extended for prevention of bleeding according to the nature of the drug infused in order to minimize patients’ suffering and reduce nursing load.

关 键 词：止血方法 外伤患者 静脉输注药物 按压止血 止血效果 抗凝药物 静脉输液 按压穿刺点 拔针后 随机方法 不同时间 抗生素 手臂 抬高 护士 屈肘 出血率 

分 类 号：R765.23[医药卫生—耳鼻咽喉科] R473.6[医药卫生—临床医学]