三联抗凝治疗患者低分子肝素脐周皮下注射部位的研究  

Explore into the peri-umbilical subcutaneous injection sites for patients subjected to triple anti-coagulation regimens

作　　者：朱敏[1] 史作霞[1] 张文彦[1] 李馨[1] 王莹[1] 

机构地区：[1]首都医科大学附属复兴医院心内科,北京100038

出　　处：《护理学杂志》2011年第23期39-40,共2页

摘　　要：目的探讨三联抗凝治疗患者低分子肝素脐周注射的最佳部位,降低皮下出血发生率。方法将389例脐周皮下注射低分子肝素同时口服拜阿司匹林、硫酸氢氯吡格雷片患者采用自身对照法,分别于脐至外侧缘连线,将左侧连线分为3等份,选择外1/3处上下5cm范围进行注射;将右侧连线分为2等份,选择1/2处上下5cm范围进行注射。两处各注射2 080例次,观察皮下出血的发生率。结果 1/3处皮下出血发生率显著低于1/2处(P<0.01)。结论三联抗凝治疗患者行低分子肝素脐周皮下注射时选择在腹部外侧部位进针,可减少皮下出血。Objective To determine peri-umbilical subcutaneous injection sites for patients subjected to triple anti-coagulation regimens,and to reduce the rate of subcutaneous hemorrhage. Methods Totally,389 patients were subjected to triple anti-coagulation regimens： they were subcutaneously injected with bay low molecular heparin and were orally medicated with bayaspirin and clopidogrel bisulfate.Patients were taken as self-controls in the study.A line was drawn horizontally through the umbilicus with the left part of the line being equally divided into 3 subparts,and the right part into 2 subparts.The area within upper and lower 5 cm of outer subpart of the left line were used as the injection site（the 1/3 group）,while the area within upper and lower 5 cm of outer subpart of the right line served as the injection site（the 1/2 group）.Both group had 2 080 times of injections respectively and the rates of subcutaneous hemorrhage rate were observed. Results The rate of subcutaneous hemorrhage at the injection sites in the 1/3 group was significantly lower than that in the 1/2 group（P0.01）. Conclusion The injection site for patients subjected to triple anti-coagulation regimens should be selected at the outer quadrant of the abdomen when nurses perform peri-umbilical subcutaneous injection of low molecular heparin in an effort to reduce subcutaneous hemorrhage rate.

关 键 词：低分子肝素 拜阿司匹林 硫酸氢氯吡格雷片 抗凝治疗 皮下注射 注射部位 脐周 皮下出血 

分 类 号：R472[医药卫生—护理学]