经皮冠状动脉介入治疗老年冠心病患者周围血管并发症的相关因素分析  

Related factors analysis of peripheral vascular complications after percutaneous coronary intervention in elderly patients with coronary heart disease

作　　者：王芳[1] 陈琪尔[2] 谭坚铃[2] 

机构地区：[1]云南省第一人民医院护理部,昆明650000 [2]中山大学护理学院内科教研室,广州510080

出　　处：《中华现代护理杂志》2014年第29期3707-3710,共4页Chinese Journal of Modern Nursing

摘　　要：目的了解老年冠心病患者经皮冠状动脉介入治疗（PCI）术后周围血管并发症的发生状况，探讨老年冠心病患者PCI术后周围血管并发症发生的相关因素。方法采用横断面调查研究方法，以便利抽样抽取行PCI术的老年冠心病患者103例，并采用自行设计的PCI术老年冠心病患者人口学资料表和疾病相关资料表进行数据收集。结果老年冠心病患者PCI术后有21．4％发生了周围血管并发症，发生最多的是局部渗血13．6％，其次是血肿4．9％、穿刺点周围皮下淤斑2．9％、前臂肿胀2．9％；不同年龄、不同婚姻状况，术前是否合并高脂血症、不同穿刺部位、不同手术时机、不同手术持续时间、不同病变血管支数、术中不同肝素用量、术中及术后不同盐酸替罗非班氯化钠注射液用量、术中硫酸氢氯吡格雷片用量，PCI术后的老年冠心病患者周围血管并发症发生状况有所不同，差异有统计学意义（P〈0．05）；Logistic回归分析发现，婚姻状况、穿刺部位、病变血管支数、术中肝素用量、术后硫酸氢氯吡格雷片是PCI术后发生周围血管并发症的危险因素。结论年龄越大、非在婚、合并高脂血症、急诊手术、手术持续时间长、经股动脉穿刺、病变血管支数多、前降支狭窄程度大、术中肝素用量大、术后使用盐酸替罗非班氯化钠注射液、硫酸氢氯吡格雷片的患者更易发生周围血管并发症，提示在今后的护理工作中，应该把此类患者作为护理的重点。Objective To understand the situation of the incidence of peripheral vascular complications after pereutaneous coronary intervention （PCI） in elderly patients with coronary heart disease, and to explore its related factors. Methods One hundred and three elderly patients with coronary heart disease after PCI were chosen according to the convenient sampling through the cross-sectional study, and were surveyed by the self- designed demographic tables and disease-related tables, and the data were collected and analyzed. Results The incidence of peripheral vascular complications was 21.4% in the elderly patients with coronary heart disease after PCI, and the incidence of local oozing bleeding was the most （ 13.6% ）, followed by 4.9% of the hematoma, 2. 9% of subcutaneous ecchymosis around puncture point, 2. 9% of forearm swelling. The occurrence of peripheral vascular complications was different in the patients with different age, marital status, combined with hyperlipidemia, puncture site, surgical time, duration of surgery, number of diseased vessels, the use of heparin during operation, postoperative use of Tirofiban and Plavix, and the differences were statistically significant （P 〈 0. 05）. Logistic regression analysis showed that the related factors of peripheral vascular complications after PCI included the marital status, puncture site, number of diseased vessels, intraoperative use of heparin, postoperative use of Tirofiban and Plavix. Conclusions The patients with older, non-marriage, emergency surgery, long time of surgery, puncture through the femoral artery, many diseased vessels, severe anterior descending artery stenosis, intraoperative use of large heparin, postoperative use of Tirofiban and Plavix are more susceptible to peripheral vascular complications, which suggests that we should put these patients as the focus of nursing in the future work.

关 键 词：老年人 冠心病 经皮冠脉介入治疗 周围血管并发症 相关因素 

分 类 号：R473.5[医药卫生—护理学]