经桡动脉冠状动脉介入术后早期握力锻炼对预防桡动脉闭塞的研究  

Study on early grip exercise in the prevention of radial artery occlusion after transradial coronary intervention

作　　者：庄燕 俞家顺 李晓静 Zhuang Yan;Yu Jiashun;Li Xiaojing(Department of Coronary Heart Disease Care Unit,Punan Hospital,Pudong New District,Shanghai 200125,China)

机构地区：[1]上海市浦东新区浦南医院心血管内科监护室,200125

出　　处：《山西医药杂志》2022年第5期487-491,共5页Shanxi Medical Journal

基　　金：上海市浦东新区卫生健康委员会面上项目(PW2019A-28)。

摘　　要：目的探讨经桡动脉冠状动脉介入治疗(TRI)后,早期握力锻炼对桡动脉闭塞(RAO)的预防作用。方法选取2020年2月至2021年2月在我院接受TRI治疗的患者90例作为研究对象,随机分为对照组、握力锻炼5 kg组和握力锻炼10 kg组,每组30例。对照组根据介入术后护理常规为基础,指导患者术后握松拳运动。握力锻炼组在对照组的基础上分别进行5 kg、10 kg的握力器握力锻炼,时间安排在术后6 h,间隔2 h锻炼1次,共2次;术后第1、第2天,每天3次,每次30回合。介入治疗前后定时经皮血氧饱和度(SpO_(2))监测,并于介入治疗前及治疗第3天给予彩色多普勒超声检测桡动脉内径及有无闭塞。结果握力锻炼组与对照组对桡动脉闭塞的影响差异有统计学意义(t=7.73,P=0.021);3组患者左右手SpO_(2)术前监测差异均无统计学意义,(P>0.05),术后不同时间段内的SpO_(2)变化对穿刺侧桡动脉闭塞结果的判断差异有统计学意义(H=16.23,P=0.001);3组桡动脉穿刺点内径介入前后差异有统计学意义[对照组:术前(0.195±0.014)与术后(0.169±0.034)cm,t=4.482,P<0.05;握力锻炼5 kg组:术前(0.191±0.015)cm与术后(0.167±0.030)cm,t=4.28,P<0.05;握力锻炼10 kg组:术前(0.198±0.013)cm与术后(0.172±0.032)cm,t=4.59,P<0.05]。结论TRI容易导致桡动脉损伤,使管腔狭窄、闭塞,通过定时血氧饱和度监测可以为局部急性闭塞提供判断依据;介入治疗术后握力锻炼可以降低桡动脉闭塞的发生率,以10 kg握力锻炼效果最佳;值得推广应用。Objective To explore the preventive effect of early grip exercise on radial artery occlusion after transradial coronary intervention.Methods A total of 90 patients who received transradial coronary intervention(TRI)treatment in our hospital from February 2020 to February 2021 were randomly divided into control group,grip strength exercise 5 kg group and grip strength exercise 10 kg group(n=30).The petients in control group were implemented postoperative nursing,and guided the patients to clench and loosen their fists after operation.In the grip strength exercise group,5 kg and 10 kg grip strength exercises were performed on the basis of the control group.The time was arranged 6 hours after operation,once every two hours,twice in total.The first and second day after operation,three times a day,30 rounds each time.SpO_(2) was monitored regularly before and after interventional treatment,and color Doppler ultrasound was given before interventional treatment on the third day of treatment to detect the diameter of radial artery and occlusion.Results There was significant difference in the effect of grip exercise group and control group on radial artery occlusion(t=7.73,P=0.021).There were no significant differences in preoperative monitoring of left and right hand percutaneous oxygen saturation among the three groups(P>0.05).The changes of percutaneous oxygen saturation in different time after operation had significant difference in judging the results of radial artery occlusion on the puncture side(H=16.23,P=0.001).There were significant differences in radial artery diameter between the three groups before and after intervention[Control group:before intervention(0.195±0.014)cm vs after intervention(0.169±0.034)cm,t=4.48,P<0.05.Grip strength exercise 5 kg group:before intervention(0.191±0.015)cm vs after intervention(0.167±0.030)cm,t=4.28,P<0.05.Grip strength exercise 10 kg group:before intervention(0.198±0.013)cm vs after intervention(0.172±0.032)cm,t=4.59,P<0.05].Conclusion Transradial coronary intervention wi

关 键 词：经桡动脉冠状动脉介入治疗 桡动脉闭塞 握力锻炼 经皮血氧饱和度 

分 类 号：R473.5[医药卫生—护理学]