桡静脉穿刺碘对比剂外渗后两种护理措施效果评价

The evaluation of two different nursing methods after iodine contrast agent extravasation through wrist radial vein channel

目的比较喜疗妥联合人工手法推拿+冰袋和冰袋+硫酸镁湿敷两种护理桡静脉穿刺碘对比剂局部外渗的效果。方法将84例行冠状动脉CTA桡静脉穿刺碘对比剂外渗患者分为实验组及常规组,每组42例,实验组采用喜疗妥外涂联合手法推拿+冰袋,常规组采用冰袋+硫酸镁湿敷,各组再根据肿胀面积分为轻、重两组,比较两种护理措施的效果。结果治疗48h后,实验组痊愈率95.2%(40/42),其余2例治疗72h后痊愈。常规组痊愈率73.8%(31/42),其余11例治疗96h后痊愈,两组疗效比较轻度亚组的效果无统计学差异,重度亚组的效果有统计学差异(P<0.05)。结论喜疗妥联合人工手法推拿+冰袋可有效治疗桡静脉穿刺碘对比剂外渗所致的局部组织损伤、疼痛,尤其在重度外渗情况下其痊愈时间、皮肤损伤、手及腕部功能等方面的疗效优于冰袋+硫酸镁湿敷。

Objective To compare with wet magnesium sulfate and ice packs and to evaluate the effect of Hirudoid com‐bine with artificial manipulation and ice packs in those patients with iodinated contrast extravasation through radial vein channel .Methods Eighty‐four patients with iodinated contrast extravasation through radial vein channel after accepted coronary CT angiography were enrolled in this study .Those patients were divided into experimental group and convention‐al group （42 cases in each group） .The experimental group was treated with Hirudoid combine with artificial manipulation and ice packs ,and the conventional group underwent wet magnesium sulfate and ice packs .In each group ,patients were divided into light and heavy groups according to the swelling area .And then ,the effects of two nursing interventions were compared in each group .Results After 48hrs ,in the experimental group ,the cure rate was 95 .2% （40/42） ,and the re‐maining two cases recovered after 72 hrs .In conventional group ,the cure rate was 73 .8% （31/42） ,and the remaining 11 cases recovered after 96 hrs .No significant difference was found between the two mild subgroups ,but significantly differ‐ence was found between the two severe subgroups （ P 〈 0 .05） .Conclusion Hirudoid combine with artificial manipulation and ice packs can effectively treat the local tissue damage and pain caused by iodinated contrast extravasation through radial vein channel .Especially ,in severe extravasation ,the effect of recovery time ,skin damage and hand and wrist function was much better than wet magnesium sulfate and ice packs .