口服华法林心房颤动患者拔出留置针后按压时间及其相关机制的研究  

Study on the compression time after removing the indwelling needle in atrial fibrillation patients with oral Warfarin and its related mechanism

作　　者：黄鸣 杨丽青 陈敏多 HUANG Ming;YANG Liqing;CHEN Minduo(Department of Cardiology,Jingdezhen NO.1 People's Hospital,Jiangxi Province,Jingdezhen,333000,China)

机构地区：[1]江西省景德镇市第一人民医院心内科,江西景德镇333000

出　　处：《中国当代医药》2023年第24期61-65,共5页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20197251);江西省景德镇市科技计划项目(20201SFZC044)。

摘　　要：目的探究口服华法林心房颤动患者拔出留置针后按压时间及其相关机制。方法选取2020年10月至2022年4月于景德镇市第一人民医院心血管内科住院接受口服华法林且国际标准化比值(INR)为2.0~3.0的300例心房颤动患者作为研究对象,按照随机数字表法分为A组(75例)、B组(75例)、C组(75例)、D组(75例)。A组采用按压4 min方法,B组采用按压6 min方法,C组采用按压8 min方法,D组采用按压10 min方法。比较四组患者出血情况、各组24 h局部淤血发生率、各凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)以及D-二聚体(D-D)]、各组患者拔除静脉留置针后按压满意率。结果四组患者出血发生率、24 h局部淤血发生率比较,差异有统计学意义(P<0.05)。治疗前,四组患者PT、APTT、TT和D-D比较,差异无统计学意义(P>0.05);治疗后,四组患者PT、APTT、TT均短于本组治疗前,D-D低于本组治疗前,C、D组患者PT、APTT、TT均短于A、B组,D-D低于A、B组,差异有统计学意义(P<0.05)。四组患者按压总满意度比较,差异有统计学意义(P<0.05)。结论对于口服华法林心房颤动患者,拔出留置针后按压8 min不仅可有效减少出血,提高患者按压满意度,同时还可保护血管,减轻患者痛苦,值得推广应用。Objective To explore the compression time after removing the indwelling needle in atrial fibrillation patients with oral Warfarin and related mechanisms.Methods From October 2020 to April 2022,300 patients with atrial fibrillation who were hospitalized in the Department of Cardiology,Jingdezhen NO.1 People's Hospital and received oral Warfarin with international normalized ratio(INR)of 2.0-3.0 were selected as the research objects.They were divided into Group A(75 cases),Group B(75 cases),Group C(75 cases),and Group D(75 cases)according to random number table method.Group A used 4-minute compression method,Group B used 6-minute compression method,Group C used 8-minute compression method,and Group D used 10-minute compression method.The bleeding situation of patients in the four groups,the occurrence rate of 24 h local congestion in each group,the coagulation function indicators(prothrombin time[PT],activated partial thromboplastin time[APTT],thrombin time[TT],and D-dimer[D-D]),and the satisfaction rate of patients in each group after pulling out the intravenous indwelling needle were compared.Results There were statistically significant differences in the incidence of bleeding and 24-hour local congestion among the four groups of patients(P<0.05).Before treatment,there were no statistically significant differences in PT,APTT,TT and D-D among the four groups of patients(P>0.05).After treatment,the PT,APTT and TT of patients of the four groups were shorter than those before treatment,and D-D was lower than that before treatment.The PT,APTT and TT of patients in Group C and Group D were shorter than those in Group A and Group B,and D-D was lower than those in Group A and Group B,with statistical significances(P<0.05).There was statistically significant difference in overall satisfaction with compression among the four groups of patients(P<0.05).Conclusion For atrial fibrillation patients with oral Warfarin,compression for 8 minutes after removing the indwelling needle can not only effectively reduce bleeding and imp

关 键 词：心房颤动 华法林 拔针 静脉留置针 按压时间 按压满意率 凝血指标 

分 类 号：R541.75[医药卫生—心血管疾病]