夹心式包扎法联合桡动脉止血器在经皮行冠状动脉介入术后的应用效果  

The application efficacy of sandwich bandaging method combined with radial artery hemostat after percutaneous coronary intervention

作　　者：孙莲莲[1] 单培仁[1] 胡伟珍[1] 张敏月[1] SUN Lianlian;SHAN Peiren;HU Weizhen;ZHANG Minyue(Department of Cardiovascular Internal Medicine,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou325000,China)

机构地区：[1]温州医科大学附属第一医院心血管内科,浙江温州325000

出　　处：《中国现代医生》2021年第6期163-166,170,共5页China Modern Doctor

基　　金：浙江省温州市科技局计划项目(2018Y0009);国家自然青年基金项目(81600341)。

摘　　要：目的观察夹心式包扎法联合动脉止血器在经皮行冠状动脉介入术后的应用效果。方法采取便利抽样法,选取2019年5—12月我院收治的确诊为冠心病且拟行经皮行冠状动脉造影术的患者210例,随机分为对照组和实验组,每组各105例。对照组在旋压式止血器压迫垫下方置入纱布(中心点包扎法),实验组采取在旋压式止血器压迫垫及锁扣的下方置入纱布(夹心形包扎法),减压时间统一为术后1 h开始减压,之后为每0.5小时放松止血器,4~6 h完全放松止血器。观察两组术后并发症(渗血、Ⅰ期压疮、Ⅱ期压疮、肿胀、疼痛≥4分)发生情况、术后舒适度及对护理工作满意度。并分析患者并发症与舒适度、舒适度与对护理工作满意之间的关系。结果两组术后渗血、Ⅱ期压疮发生率比较,差异无统计学意义(P>0.05),其他术后并发症(Ⅰ期压疮、肿胀、疼痛≥4分)发生率比较,差异有统计学意义(P<0.05)。实验组舒适率显著高于对照组,差异有统计学意义(P<0.05)。将患者根据舒适程度进行分析,不舒适组患者并发症(Ⅰ期压疮、肿胀、疼痛≥4分)发生率显著高于舒适组,差异有统计学意义(P<0.05)。经Spearman相关性分析,患者术后舒适度[(2.3±0.9)分]与对护理工作满意度[(3.0±0.8)分]呈正相关(r=0.639,P<0.001)。结论夹心包扎法将纱布垫入锁扣可作为一个缓冲力量,可减轻锁扣对皮肤的直接压迫损伤,有效降低与止血器相关的术后并发症,可提升患者舒适度及对护理工作的满意度。Objective To observe the application efficacy of sandwich bandaging method combined with radial artery hemostat after percutaneous coronary intervention.Methods By convenience sampling method,a total of 210 patients diagnosed with coronary heart disease and scheduled for percutaneous coronary angiography in our hospital from May to December 2019 were selected and randomly divided into control group and experimental group,105 cases in each group.In the control group,gauze was placed under the compression pad of the spinning hemostat(central point bandaging method),while in the experimental group,gauze was placed under the compression pad and lock of spinning hemostat(sandwich bandaging method).The decompression time was unified after operation,and the hemostat was relaxed every 0.5 hours,then completely after 4-6 hours.The incidence of postoperative complications(bleeding,stageⅠpressure ulcer,stageⅡpressure ulcer,swelling,pain≥4 points),postoperative comfort and satisfaction with nursing work were observed.And the relationship between complications and comfort,comfort and nursing satisfaction were analyzed.Results There was no significant difference in the incidence of postoperative bleeding and stageⅡpressure ulcer between the two groups(P>0.05),but there was significant difference in the incidence of other postoperative complications(stageⅠpressure ulcer,swelling,pain≥4 points)(P<0.05).The comfort rate of the experimental group was significantly higher than that of the control group(P<0.05).The incidence of complications(stageⅠpressure ulcer,swelling,pain≥4 points)in the uncomfortable group was significantly higher than that in the comfortable group(P<0.05).Spearman correlation analysis showed that postoperative comfort([2.3±0.9]points)was positively correlated with nursing satisfaction([3.0±0.8]points)(r=0.639,P<0.001).Conclusion Sandwich bandaging method can be used as a buffering force by putting gauze into the lock buckle,which can reduce the direct compression damage of the lock buckle to

关 键 词：包扎 桡动脉 止血器 经皮行冠状动脉介入术 

分 类 号：R473.5[医药卫生—护理学]