冠状动脉搭桥术患者取血管下肢不同抬高角度的研究  

Study on different elevation angles of lower limbs during leg vein graft harvesting for coronary artery bypass grafting

作　　者：黄娟 谢家湘 邵永丰 Huang Juan;Xie Jiaxiang;Shao Yongfeng(Cardiovascular Surgery Ward 2,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院心脏大血管外科2病区,江苏南京210029

出　　处：《护理学杂志》2022年第14期23-26,52,共5页Journal of Nursing Science

基　　金：国家自然科学基金资助项目(81974033)

摘　　要：目的观察不同抬高角度对冠脉搭桥患者取血管下肢舒适度的影响。方法将冠脉搭桥术后下肢取血管患者120例,按抽签法随机分为取血管下肢抬高20°组40例、抬高30°组40例、抬高40°组40例(最终完成研究38例)。观察比较三组术后第2~5天取血管下肢肿胀程度、舒适度评分、疼痛评分以及并发症发生率,采用重复测量方差分析比较其差异。结果冠脉搭桥术患者取血管下肢不同抬高角度,不同时间点取血管下肢肿胀程度、舒适度评分、疼痛评分差异有统计学意义(均P<0.05),其中40°组肿胀程度最轻,30°组舒适度评分最高,疼痛评分最低。并发症发生率三组比较差异无统计学意义(P>0.05),但30°组并发症最少。结论冠脉搭桥术患者取血管下肢抬高30°组患者虽然取血管下肢肿胀程度较下肢抬高40°组患者重,但是在三组中舒适度评分最高、疼痛评分最低、并发症最少,综合考虑到患者舒适度以及临床效果,冠脉搭桥患者取血管下肢抬高30°为宜。Objective To observe the effect of different elevation angles of lower limbs on comfort level of patients during leg vein graft harvesting for coronary artery bypass grafting(CABG).Methods Totally,120 patients after CABG performed with prior leg vein graft harvesting were randomly divided into either of the 3 groups of 40 cases each with the affected leg elevated to various angles:the 20°group,the 30°group and the 40°group(38 cases completed the study).The degree of swelling,comfort score,pain score and complication rate of the affected leg were observed 2-5 days after operation.The differences in the three groups were compared by running repeated measures analysis of variance.Results The degree of swelling,comfort score,and pain score observed at various time points showed significant differences(P<0.05 for all),with the 40°group having the mildest swelling,and the 30°group having the highest comfort scores versus the lowest pain scores.Complication incidence rate of the affected leg showed no significant difference among the 3 groups(P>0.05),though the 30°group had the lowest incidence rate.Conclusion Though the leg elevation in the 30°group had more severe leg swelling than the 40°group,it outperformed others with highest comfort scores,the lowest pain scores,and the lowest incidence rate of complication.In view of patient comfort and clinical effect,leg elevation at 30°is recommended to patients after CABG performed with prior leg vein graft harvesting.

关 键 词：冠状动脉搭桥术 取血管下肢 抬高角度 下肢肿胀 舒适度 疼痛 并发症 体位护理 

分 类 号：R473.6[医药卫生—护理学]