预防经桡动脉冠状动脉造影或介入术后桡动脉闭塞的最佳证据应用效果评价  

Application effect evaluation of the best evidence for the prevention of radial artery occlusion after transradial coronary angiography or intervention

作　　者：周晓美 曹光岩 王浩 王素云 Zhou Xiaomei;Cao Guangyan;Wang Hao;Wang Suyun(Department of Cardiology,Qilu Hospital of Shandong University(Qingdao),Qingdao 266000,China;Department of General Medicine,Qilu Hospital of Shandong University(Qingdao),Qingdao 266000,China;Department of Nursing,Qilu Hospital of Shandong University(Qingdao),Qingdao 266000,China)

机构地区：[1]山东大学齐鲁医院(青岛)心内科,青岛266000 [2]山东大学齐鲁医院(青岛)全科医学科,青岛266000 [3]山东大学齐鲁医院(青岛)护理部,青岛266000

出　　处：《中国实用护理杂志》2023年第8期561-567,共7页Chinese Journal of Practical Nursing

基　　金：山东大学齐鲁医院(青岛)科研启动基金(QDKY2019HL01);青岛市医疗卫生B类重点学科建设项目(青卫科教字〔2019〕9号)。

摘　　要：目的将预防经桡动脉冠状动脉造影或介入术后桡动脉闭塞的最佳证据应用于临床实践并评价其效果。方法本研究为类实验研究。基于证据持续质量改进模式,运用循证实践方法获取最佳证据,制订审查指标,分析实践过程中的障碍因素并采取行动策略。采用便利抽样法,选取山东大学齐鲁医院(青岛)心内科2020年6月1—30日行经桡动脉冠状动脉造影或介入治疗的患者88例作为基线审查组,采用原有的围手术期管理方案;选取2020年9月1—30日行该治疗的患者94例作为证据应用组,采用基于最佳证据的围手术期管理方案。比较2组患者各审查指标执行率、术后桡动脉闭塞发生率、压迫疼痛程度、患者舒适度等指标。结果除审查指标4外,证据应用组指标1、2、3、5、6、7、8执行率分别为100.0%(94/94)、100.0%(94/94)、11.7%(11/94)、88.3%(83/94)、100.0%(94/94)、100.0%(94/94)、85.1%(80/94),基线审查组各指标执行率均为0,2组比较差异均有统计学意义(χ^(2)值为9.00~178.02,均P<0.05);证据应用组桡动脉闭塞发生率、疼痛数字评定量表评分>3分的发生率分别为2.1%(2/94)、3.2%(3/94),低于基线审查组的14.8%(13/88)、23.9%(21/88),差异均有统计学意义(χ^(2)=8.01、15.21,均P<0.05);证据应用组的患者舒适率为96.8%(91/94),高于基线审查组的63.6%(56/88),差异有统计学意义(χ^(2)=30.10,P<0.05)。结论将预防经桡动脉冠状动脉造影或介入术后桡动脉闭塞的最佳证据应用于临床,可规范医护人员行为,降低术后桡动脉闭塞发生率,降低压迫疼痛程度,提高患者舒适度。Objective To apply the best evidence for the prevention of radial artery occlusion after transradial coronary angiography or intervention to clinical practice and evaluate its effect.Methods This was a quasi-experimental study.Based on the evidence continuous quality improvement model,evidence-based practice method was used to obtain the best evidence,formulated review indicators,analyzed the obstacles in the practice process and took action strategies.The 88 patients who underwent transradial coronary angiography or intervention in the Cardiology Department of Qilu Hospital of Shandong University(Qingdao)from June 1 to 30,2020 were selected as the baseline review group by convenience sampling.The 94 patients who underwent this treatment from September 1 to 30,2020 were selected as the evidence application group.The baseline review group used the original perioperative management plan,and the evidence application group used the perioperative management plan based on the best evidence.The implementation rate of each review indicator,the incidence of radial artery occlusion,the degree of compression pain,and the comfort level of patients were compared between the two groups.Results The implementation rates of review indicators 1,2,3,5,6,7,8 in the evidence application group were 100.0%(94/94),100.0%(94/94),11.7(11/94),88.3%(83/94),100.0%(94/94),100.0%(94/94),85.1%(80/94),respectively,which were higher than those in the baseline review group(all 0),except for the review indicator 4,the differences were statistically significant(χ^(2)values were 9.00-178.02,all P<0.05).The incidence of radial artery occlusion and the incidence of pain Numerical Rating Scale>3 points in the evidence application group were 2.1%(2/94)and 3.2%(3/94),respectively,which were lower than 14.8%(13/88)and 23.9%(21/88)in the baseline review group;the comfort level of patients in the evidence application group was 96.8%(91/94),which was higher than 63.6%(56/88)in the baseline review group.The differences were statistically significant(χ^(2)=8.

关 键 词：桡动脉闭塞 经桡动脉冠状动脉造影 经桡动脉冠状动脉介入 证据应用 

分 类 号：R541.4[医药卫生—心血管疾病]