老年冠状动脉介入治疗患者三种动脉止血方法术后舒适度的比较  

Comfort after percutaneous coronary intervention in elderly patients:comparison of closure device with direct compression for hemostasis

作　　者：杨婷[1] 杨娉[1] 张艳[1] 李帼英[1] 郑小琴[1] 

机构地区：[1]中国人民解放军总医院老年心血管病研究所,北京市100853

出　　处：《中华老年多器官疾病杂志》2010年第2期155-158,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的比较冠状动脉介入治疗(PCI)三种动脉止血方法对老年患者术后舒适度的影响,探讨适宜的护理方案。方法 396例接受冠状动脉介入治疗的老年患者,按股动脉穿刺点止血方法分为手工压迫组(A组,n=162),Femostop压迫组(B组,n=106),和Perclose组(C组,n=128),监测各组患者入院时、术前、术后6h、术后1d内心率、血压变化,睡眠困难、胃肠道症状、躯体疼痛以及出血血栓事件的发生率。结果与手工压迫组比较,Per-close组患者术后生命体征波动小,睡眠困难、排尿障碍、胃肠道症状、躯体疼痛发生程度较轻;Femostop组术后舒适度各指标与手工压迫组相比无差异;Perclose组出血并发症明显低于Femostop压迫组及手工压迫组。三组血栓事件的发生率无明显差异。结论对接受PCI治疗的老年患者,Perclose止血方法可明显改善患者术后舒适程度;对接受不同止血方法的患者应采取不同的护理方案,以改进护理效率及质量。Objective To compare patient＇s comfort after hemostasis with arteriotomy closure device versus manual or device compression after percutaneous coronary interventions （PCI） in the elderly patients and evaluate their impact on nursing procedures.Methods A total of 396 elderly （aged 60 years or over） patients who underwent PCI were enrolled in this study.Patients were divided into 3 groups according to whether receiving manual compression （group A,n=162）,Femostop device compression （group B,n=128） or arteriotomy closure with Perclose for hemostasis （group C,n=106） after PCI.Changes of heart rate,blood pressure,degree of insomnia,dysuria,gastrointestinal symptom score and bleeding or thrombotic events were recorded before and at 6 h,24 h after PCI procedure.Results Compared with those patients receiving either manual compression or Femostop compression,patients receiving Perclose vascular closure showed less fluctuation of vital signs and better indexes of post-procedure comfort,with lower rate of post-procedure bleeding,but no differences were observed between those receiving Femostop or manual compression.No difference in thrombotic complications was found among three groups.Conclusion Hemostasis with arteriotomy closure device may improve post-procedure comfort and reduce bleeding complications in elderly patients.Different nursing protocol should be adapted for patients receiving different hemostasis to improve efficiency and quality of nursing care.

关 键 词：冠状动脉疾病 介入治疗 止血 老年 

分 类 号：R541.4[医药卫生—心血管疾病]