经股动脉路径行冠状动脉造影术后不同护理体位的研究

Study on different nursing positions of postoperative patients after undergoing coronary angiography viafemoral artery path

[目的]探讨经股动脉路径行冠状动脉造影术后改变病人体位,对病人术后不良反应及并发症的影响。[方法]选择我院心内科2008年1月—2009年12月行冠状动脉造影手术的住院病人150例,将其随机分为两组,对照组68例,实验组82例,观察24 h。对照组病人术后平卧位,沙袋压迫穿刺处6 h,术肢伸直制动,卧床24 h后下床活动。实验组术后在沙袋压迫穿刺处6 h基础上,指导病人侧卧位与平卧位交替,术侧肢体伸直。[结果]对照组有9例(13.2%)病人出现皮下血肿或皮肤淤斑,48例(70.6%)出现腰背酸痛,19例(27.9%)出现腹胀,35例(51.5%)出现失眠,10例(14.7%)出现排尿困难以及1例(1.5%)假性动脉瘤。实验组有10例(12.2%)病人出现皮下血肿或皮肤淤斑,15例(18.3%)出现腰背酸痛,7例(8.5%)出现腹胀,5例(6.1%)出现失眠,1例(1.2%)排尿困难者以及1例(1.2%)假性动脉瘤。[结论]冠状动脉造影术后病人采取平卧位与侧卧位交替的护理体位,能够减少病人术后并发症及不良反应的发生,增加舒适度。

Objective：To probe into the influence of adverse reaction and complications of changing patients＇ body position after undergoing coronary angiography via femoral artery.Methods：A total of 150 inpatients undergoing coronary angiography via femoral artery in our hospital from January 2008 to December 2009 were randomly divided into control group（n=68） and test group（n=82） and had been observed for 24 hours.Patients of control group were received the traditional methods including taking horizontal position,pressing the puncture site 6h with sand bag,keeping the operative extremity extending and immobilizing for 24h.Based on the pressing of puncture site with sandbag for 6 hrs,patients of test group were kept operative extremity extending but changing body posture horizontal position and lateral position in turns.Results：In control group,9 cases（13.2%） were with subcutaneous hematoma or skin ecchymosis,48 cases（70.6%） with different degrees of back pain,19 cases（27.9%） with abdominal distention,35 cases（51.5%） with insomnia,10 cases（14.7%） with dysuresia and 1 case（1.5%） with false aneurysm.In test group,10 cases（12.2%） were with subcutaneous hematoma or skin ecchymosis,15 cases（18.3%） with different degrees of back pain,7 cases（8.5%） with abdominal distention,5 cases（6.1%） with insomnia,1 case（1.2%） with dysuresia and 1 case（1.2%） with false aneurysm.Conclusion：Adopting horizontal position and lateral position alternately as nursing position for patients undergoing coronary angiography could reduce their postoperative complications and adverse reactions and increase comfort level of them.