经桡动脉径路冠状动脉介入治疗致前臂张力性血肿的处理方法  

Processing Method of Forearm Tension Hematoma by Transradial Coronary Intervention

作　　者：高振[1] 陈洁琼[2] 周明[1] 党书毅[1] 朱未来[3] 

机构地区：[1]湖北医药学院附属太和医院心血管内科,湖北省十堰市442000 [2]湖北医药学院附属太和医院重症医学科,湖北省十堰市442000 [3]湖北医药学院附属太和医院药学部,湖北省十堰市442000

出　　处：《中国动脉硬化杂志》2013年第9期845-848,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的通过研究经桡动脉径路冠状动脉介入治疗后患者出现前臂张力性血肿时,比较手工压迫法、单独绷带压迫法和绷带压迫联合脱水治疗法的应用效果,为临床出现前臂血肿后进行科学处理提供依据。方法回顾我科4年冠状动脉介入治疗后出现215例前臂张力性血肿患者,采用手工压迫、单独绷带压迫和绷带压迫联合速尿、甘露醇、地塞米松等脱水治疗,并用硫酸镁溶液湿敷等方法处理后,对血肿处理后的病例进行统计学分析,比较不同处理方法的效果差异。结果 215例前臂血肿患者中手工压迫组69例与单独绷带压迫组70例比较,肿胀消退时间、手指末端血供和功能改善为良好的出现时间、周围皮肤温度增加出现的时间、前臂臂围均无明显改善(P>0.05);绷带压迫联合脱水治疗组76例与手工压迫组69例比较,前臂肿胀消退时间、手指末端血供和功能改善为良好的出现时间、周围皮肤温度增加出现的时间、前臂臂围均有明显缩小(P<0.05);绷带压迫联合脱水治疗组76例与单独绷带压迫组70例比较,前臂肿胀消退时间明显缩短(P<0.05),周围皮肤温度增加出现的时间稍有缩短(P>0.05),手指末端血供和功能改善为良好的出现时间明显缩短(P<0.05);在出现肿胀压迫后3 h观察前臂臂围,相对于未穿刺臂臂围稍有缩小(P>0.05)。结论经桡动脉径路冠状动脉介入治疗后导致前臂张力性血肿,人工压迫与弹力绷带效果相当,但在弹力绷带压迫基础上,同时积极进行脱水等综合处理,方法简便,疗效确切、可靠、安全。Aim To study the application effect of artificial compression and elastic bandages and bandages with dehydration, when the forearm tensition hematoma occurred after transradial coronary intervention （TRI）, to investigate the advantages and disadvantages of the three different methods in the hematoma elimination, and to provide the method of sci- entific treatment when the hematoma were found. Methods Using a hand pressure （ A group） and bandages （ B group） and bandage compress with dehydration （C group） to deal with forearm tensition hematoma in 215 patients, during 4 years in our department. The ANOVA was used in statistical analysis, and the effects with three different methods of processing were compared. Results In the 215 patients of forearm tensition hematoma, the comparison of group A and group B, the average time of the swelling subsiding, the time of finger blood supplying and function, the time of occurrence of the surrounding skin temperature increase, and forearm arm circumference were not improved （ P 〉 0. 05 ）, the difference was not statistically significant; the 70 patients in B group were given in compression by the tension bandage, the 76 pa- tients in C group were given in compression by the tension bandage and dehydrated with mannitol or dexamethasone and so on; by comparing C group with B group, the time of forearm subsiding was shortened obviously （ P 〈 0. 05 ）, the differences has statistics significance ; the skin temperature had risen slightly （P 〉 0.05）, the difference has no statistic significance; the time was reduced obviously, which is improvement time of blood and function of the finger, and the arm circumferenceof forearm has slightly reduces with normal upper limb （ P 〉 O. 05 ）. Conclusions The bandage plus dehydration treatment was simple and reliable, when the forearm tensition hematoma were caused after the transradial coronary interven- tion.

关 键 词：经桡动脉径路冠状动脉介入治疗 前臂张力性血肿 人工压迫 绷带压迫 脱水治疗 

分 类 号：R5[医药卫生—内科学]