心房颤动患者导管消融术后肢体制动与卧床时间研究

Limb immobilization and bedridden time after catheter ablation for patients with atrial fibrillation

目的探讨心房颤动导管消融术后肢体制动与卧床时间对并发症、舒适程度的影响。方法将160例经房间隔穿刺行房颤消融术的患者按照时间顺序分为对照组(42例)、观察1组(60例)、观察2组(58例)。对照组采用沙袋压迫穿刺部位6h,8h后可床旁活动;观察1组术后沙袋压迫穿刺部位2h,4h后床旁活动;观察2组术后沙袋压迫穿刺部位2h,6h后床旁活动。结果三组出血、血肿发生率差异有统计学意义(P<0.05),其中观察1组出血、血肿发生率高于对照组和观察2组;回室后4h、6h、8h三组疼痛评分比较,差异有统计学意义(均P<0.01),其中对照组疼痛分值最高,其次是观察2组,观察1组最低;三组尿潴留发生率比较,差异有统计学意义(P<0.05)。结论沙袋压迫2h,6h后下床活动没有增加房颤消融术患者出血、血肿、假性动脉瘤,动静脉瘘等并发症发生率,患者腰背部疼痛相对较轻。

Objective To investigate the influence of limb immobilization and bedridden time on complications and comfort of patients with atrial fibrillation（AF）after catheter ablation.Methods A total of 160 AF patients receiving catheter ablation via transseptal access were randomly divided into a control group（n=42）,an intervention group 1（n=60）and an intervention group 2（n=58）.The sandbag compression duration at the puncture site was 6h,2hand 2hfor the three groups accordingly,and ambulation began8 h,4hand 6hafter the operation respectively.Results There were significant differences among the 3groups in the incidence rates of bleeding and hematoma（P〈0.05）,with the intervention group 1of the highest incidence.Significant differences were found among the 3groups regarding the pain scores at 4,6and 8hfor them after operation,with the control group ranking the 1st,followed by the intervention group 2and 1（P〈0.01 for all）.Significant differences were also observed in the incidence rates of urine retention among the 3groups（P〈0.05）.Conclusion The strategy of 2hsandbag compression and 6himmobilization will not increase the incidence of complications after AF ablation such as bleeding,hematoma,pseudoaneurysm and arteriovenous fistula,and lower patients′back pain.