桡动脉置管行有创血压监测在抢救急性心力衰竭中的应用及护理

Application and nursing in using radial artery detained trocar for invasive blood pressure monitoring in patients with acute heart failure

目的探讨对急性心力衰竭患者抢救期间采取桡动脉穿刺置管进行有创动脉血压监测的护理要点,并比较两种不同的桡动脉置管固定方法在有创血压监测中的疗效。方法选择2010年6月—2012年6月在我院心内科住院抢救的126例急性心力衰竭患者,对入选患者均实施桡动脉穿刺置管后进行有创血压监测,患者按不同的桡动脉置管固定方法随机分为常规固定组63例,自制夹板固定组63例,观察两组患者有创血压监测的护理效果及并发症情况。结果 126例患者均成功穿刺桡动脉后留置导管进行有创血压监测,与常规固定组比较,自制夹板固定组患者在留置管堵塞、留置管折曲、局部出血、血肿、留置管脱落等并发症的总发生率方面降低(6.35%vs 25.39%,χ2=8.588,P<0.01)。结论在急性心力衰竭患者抢救期间实施桡动脉穿刺置管行有创血压监测安全、成功率高,为使用血管活性药物抢救患者提供准确可靠的血压监测指标,并能显著减少医务人员的工作量。使用自制夹板固定桡动脉置管能显著降低并发症的发生。

Objective To investigate key points of nursing in using radial artery detained trocar for invasive blood pressure monitoring （ IBPM ） in patients with acute heart failure （AHF） and compare the effects of two kinds of fixed ways for radial artery detained troear. Methods 126 AHF patients who hospitalized in our department of cardiology from June 2010 to June 2012 were enrolled and randomly divided into two groups： control group in which the detained trocars of patients were fixed in routine way and experimental group in which the detained troears were fixed by self-made splintages. Results All enrolled eases were successfully punctured and inserted detained trocars in radial artery for IBPM. Compared with control group, patients in experimental group had less incidence rate of complications （6. 35 % vs 25.39% , X2 = 8. 588, P 〈 0. O1 ） . Conclusion U- sing radial artery detained trocar for IBPM in rescuing AHF patients were feasible and safe. It not only provided reliable blood pressure monitoring indicators for using vasoactive agents during rescue time, but also reduced work load of medical staffs significantly. Using self-made splintages to fix radial artery detained trocar can decrease the incidence rates of complications.