经桡动脉行冠状动脉介入治疗术后优化压迫时间的效果评价  

EVALUATION OF OPTIMIZING PRESSING TIME AFTER TRANSTRADIAL CORONARY INTERVERTION

作　　者：郑雪梅[1] 常芸[1] 张倩[1] 周芳[1] 张文[1] 于涛[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心血管内科,江苏省南京市210006

出　　处：《中国煤炭工业医学杂志》2016年第2期289-292,共4页Chinese Journal of Coal Industry Medicine

基　　金：江苏省一级学科重点学科护理学开放基金项目(编号:NYHL201206)

摘　　要：目的探讨经桡动脉途径行冠状动脉介入治疗(TRI)术后压迫时间优化的安全性及优越性。方法将符合纳入标准的238例TRI术后的患者,随机分为二组。观察组患者120例,将TRI术后首次压迫器放松时间改为术后1h,术后4h取下压迫器;对照组患者118例,按照护理常规(首次压迫器放松时间为术后2h,术后6h取下压迫器)执行。比较二组患者在术侧肢体供血和对患者舒适度的影响。结果与对照组相比,(1)术后24h术侧肢体末梢血氧饱和度(SpO2)高于对照组,差异具有统计学意义(P<0.05)。(2)术后24h和1个月随访,二组患者的术侧桡动脉收缩压(SAP)差异无统计学意义。(3)术后2h和4h Kolcaba的舒适状况量表(General Comfort Questionnaire,GCQ)评分明显高于对照组,均由低度舒适改善为中度舒适,差异具有统计学意义(P<0.05)。结论 TRI术后优化压迫时间后,在有效止血的前提下,不仅能改善患者术侧肢体指端末梢的供血,有利于术侧肢体功能的恢复,还能明显增加患者舒适度,提高患者依从性和满意度,因此值得在临床中进一步推广和借鉴。Objective To investigate the safety and superiority of the optimized pressing time after transradial coronary intervention（TRI）.Methods A total of 236 post-TRI patients who met inclusion criteria were randomly divided into two groups.One was 4-hour pressing time group with the initial pressing device loosening occasion as 1 hour after procedure（treatment group,n=120）.The another was 6-hour pressing time group with the initial pressing device loosening occasion as 2 hours（control group,n=118）.The effects on blood supply of limbs,structure alterations of radial arteries on procedure side and degree of comfort were compared.Results The procedure-sided limb SPO2 at 24 hours after TRI in the treatment group were significantly higher compared with the control group（P〈0.05）.No significant difference in the procedure-sided radial artery SAP was observed between the two groups at 24 hours and 1 month follow-up.The treatment group was associated with significantly higher score of general comfort questionnaire（GCQ）compared with the control group at 2 hours and 4 hours,with the transformation totally from low degree of comfort to high degree of comfort（P〈0.05）.Conclusion It is suggested that optimizing pressing time after TRI,which not only helps hemostasis,improves blood supply of procedure-sided limbs,but apparently increases comfort degree and enhances compliance and satisfaction of patients.

关 键 词：TRI 压迫时间 末梢血氧饱和度(SpO2) 术侧桡动脉SAP 舒适度 

分 类 号：R473.5[医药卫生—护理学]