止血贴在经桡动脉行冠状动脉造影和/或介入治疗术后伤口管理中的应用  

Application of hemostatic bandage in wound management after transradial coronary angiography and/or interventional therapy

作　　者：段俊滔[1] 张赛 刘聪颖 王润[1] 李艳敏 杨林承[1] 唐熠达 童素梅[1] Duan Juntao;Zhang Sai;Liu Congying;Wang Run;Li Yanmin;Yang Lincheng;Tang Yida;Tong Sumei(Department of Cardiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院心内科,北京100191

出　　处：《中国实用护理杂志》2023年第9期663-669,共7页Chinese Journal of Practical Nursing

基　　金：中国医学科学院医学科研管理项目(2021RU003)。

摘　　要：目的探讨止血贴在经桡动脉行冠状动脉造影和/或介入治疗术后伤口安全性及舒适性方面的临床应用效果。方法本研究为实验性研究。选取2022年7—10月在北京大学第三医院心内科经桡动脉行冠状动脉造影和/或介入治疗的400例患者为研究对象,采用信封法随机分为止血贴组和气囊腕带组,每组200例,止血贴组和气囊腕带组分别采用止血贴和止血气囊压迫器作为桡动脉止血装置,观察并比较2组患者术后止血效果、止血器使用时间、并发症发生率、伤口疼痛程度、术侧手指麻木程度及止血器舒适程度情况。结果止血贴组和气囊腕带组止血成功率分别为98.5%(197/200)和99.0%(198/200),差异无统计学意义(χ^(2)=0.20,P>0.05);止血贴组和气囊腕带组止血器使用时间分别为(6.23±0.47)、(17.01±7.74)h,差异有统计学意义(t=-19.66,P<0.01);止血贴组和气囊腕带组并发症发生率分别为13.5%(27/200)和29.5%(59/200),差异有统计学意义(χ^(2)=8.01,P<0.05),其中,止血贴组和气囊腕带组发生术侧肢体肿胀分别为21例和54例,差异有统计学意义(U=16689.50,P<0.01);止血贴组在术后即刻的伤口疼痛程度(U=13669.50,P<0.01)、术后即刻和术后1 h的术侧手指麻木程度(术后即刻:U=17838.00,P<0.05;术后1 h:U=13342.50,P<0.01)、术后即刻和术后4、8、12 h舒适程度方面(术后即刻:U=9966.50,P<0.01;术后4 h:U=12851,P<0.01;术后8 h:U=14900,P<0.01;术后12 h:U=15920,P<0.01)均优于气囊腕带组,差异均有统计学意义。结论止血贴在经桡动脉行冠状动脉造影和/或介入治疗术后伤口止血效果好,压迫时间短,并发症发生率低,伤口疼痛程度、术侧手指麻木程度较轻,止血器舒适程度较高,值得临床推广。Objective To explore the clinical effectiveness of hemostatic bandage on wound safety and comfort after transradial coronary angiography and/or interventional therapy.Methods This was a experimental study.A total of 400 consecutive patients who underwent transradial coronary angiography and/or interventional therapy in the Department of Cardiology,Peking University Third Hospital from July to October 2022 were enrolled and randomly divided into the hemostatic bandage group and the hemostatic balloon compressor group by the envelope method with 200 cases in each group.The hemostatic bandage group and the hemostatic balloon compressor group were treated with hemostatic bandage and hemostatic balloon compressor as transradial artery hemostatic device,respectively,to observe and compare postoperative hemostatic effect,hemostat use time,complication rate,postoperative pain,the degree of numbness in the finger on the operated side and wristband comfort between the two groups.Results The hemostatic success rate was 98.5%(197/200)and 99.0%(198/200)in the hemostatic bandage and the hemostatic balloon compressor group,respectively,with no statistical difference(χ^(2)=0.20,P>0.05).The hemostat use time in the hemostatic bandage group and the hemostatic balloon compressor group was(6.23±0.47)h and(17.01±7.74)h,respectively,and the difference was statistically significant(t=-19.66,P<0.01).The incidence of complications in the hemostatic bandage group and the hemostatic balloon compressor group was 13.5%(27/200)and 29.5%(59/200),respectively,and the difference was statistically significant(χ^(2)=8.01,P<0.05).Among the complications,swelling occurred in 21 individuals of the hemostatic bandage group and 54 individuals of the hemostatic balloon compressor group with statistically significant differences(U=16689.50,P<0.01).Besides,the hemostatic bandage group was significantly better than the hemostatic balloon compressor group with statistically significant differences in wound pain at immediate postoperative(U=13669.50,P<0.

关 键 词：经皮冠状动脉介入疗法 安全性 舒适性 止血贴 桡动脉伤口 效果评价 

分 类 号：R541.4[医药卫生—心血管疾病]