4种不同注射方式对低分子肝素致不良反应的观察与研究  

Observation and study on adverse reactions caused by four different injection methods of low-molecular weight heparin

作　　者：叶红[1] 王晶晶[1] 甘茜茜 李银 Ye Hong;Wang Jingjing;Gan Qianqian;Li Yin(Department of Nursing,Affiliated Chuzhou Clinical College of Anhui Medical University,Chuzhou Municipal First People Hospital,Chuzhou 239001,China)

机构地区：[1]安徽医科大学附属滁州医院护理部,安徽滁州239001

出　　处：《实用药物与临床》2025年第2期127-132,共6页Practical Pharmacy and Clinical Remedies

基　　金：安徽医科大学临床科学基金(2021xkj206)。

摘　　要：目的探索低分子肝素皮下注射方法对皮下出血和局部疼痛的影响。方法选取安徽医科大学附属滁州医院2021年12月至2022年7月于心内科住院的48例患者,将其设定为观察1组,采用自身对照的方法皮下注射低分子肝素,左侧腹壁(A组)以捏皮技术皮下注射,右侧腹壁(B组)以脐周鼓腹垂直进针技术进行注射,两组均采用1 ml注射器,推注时间均为10 s,停留5 s,垂直拔针后按压3 min;选取2022年6月至2023年9月于心内科住院的49例患者,将其设定为观察2组,同样采用自身对照的方法皮下注射低分子肝素,左侧腹壁(C组)以改良捏皮技术皮下注射,右侧腹壁(D组)以改良脐周鼓腹垂直进针技术进行注射,两组均采用1 ml注射器、“气锁”技术、定位标尺、推注时间均为10 s,停留5 s,两组垂直拔针后均不按压;分别比较两个观察组4种注射方法引起的皮下出血和局部疼痛情况。结果观察1组中,A组与B组皮下出血发生率分别为54.2%、33.3%,硬结发生率分别为29.2%、10.4%;注射后两组皮下出血发生率、出血严重程度、硬结发生率差异均具有统计学意义(P<0.05)。观察2组中,C组与D组皮下出血发生率分别为12.2%、10.2%,两组均未发生硬结;注射后两组皮下出血发生率、出血严重程度、硬结发生率差异均无统计学意义(P>0.05)。4种注射方法注射时疼痛分值分别为2.60±0.76、1.04±0.65、0.65±0.69、0.53±0.65;A组与B、C、D组各项数据比较,差异均具有统计学意义(P<0.05);而C组与D组疼痛分值比较,差异无统计学意义(P>0.05)。结论改良注射方法前,脐周鼓腹垂直进针皮下注射低分子肝素较捏皮垂直进针能降低其出血发生率和严重程度,降低硬结发生率、减轻疼痛;而改良后的捏皮技术和脐周鼓腹垂直进针皮下注射低分子肝素均能显著降低出血发生率和严重程度,无硬结发生、疼痛不明显,值得临床推广使用。Objective To explore the effect of subcutaneous injection methods of low molecular weight heparin on subcutaneous hemorrhage and local pain.Methods A total of 48 patients admitted to the Cardiology Department of Affiliated Chuzhou Hospital of Anhui Medical University from December 2021 to July 2022 were selected as observation group 1,and subcutaneous injection of low-molecular weight heparin was performed by self-control method;subcutaneous injection was performed on the left abdominal wall(group A)by kneading skin technique,and the technique of vertical injection into periumbilical drum abdomen was performed on the right abdominal wall(group B).The 1 ml syringes were used in both groups,and the injection time was 10 s,with a 5-second pause and a 3-second press after vertically pulling out the needle.A total of 49 patients admitted to the Department of Cardiology from June 2022 to September 2023 were selected as observation group 2.Subcutaneous injection of low-molecular weight heparin was also performed by self-control method.Subcutaneous injection was performed on the left abdominal wall(group C)with improved kneading skin technique,and on the right abdominal wall(group D)with improved vertical injection into periumbilical drum abdomen.In both groups,1 ml syringe,"air lock"technology,and positioning scale were used;the injection time was 10 s,with a 5-second pause.No pressure was applied after vertical needle extraction in both groups.Subcutaneous bleeding and local pain caused by 4 injection methods were compared in two observation groups.Results In observation group 1,the incidence of subcutaneous hemorrhage in group A and group B was 54.2%and 33.3%,respectively;the incidence of induration was 29.2%and 10.4%,respectively;the differences in the incidence of subcutaneous bleeding,bleeding severity and induration rate after injection were statistically significant between the two groups(P<0.05).In observation group 2,the incidence of subcutaneous hemorrhage in group C and group D was 12.2%and 10.2%,respectively

关 键 词：低分子肝素 脐周鼓腹 捏皮技术 不良反应 

分 类 号：R969[医药卫生—药理学]