无创肢体远端缺血预处理对经桡动脉介入诊疗术后患者舒适度的影响

Effects of remote ischemic preconditioning on comfort level of patients after radial artery intervention

目的探讨无创肢体远端缺血预处理对经桡动脉行冠状动脉介入诊疗术(transradial angiography and intervention,TAI)后患者舒适程度的影响。方法采用便利抽样法,选取2018年6—12月在新疆医科大学第一附属医院冠心病二科住院的冠心病患者160例,所有患者均行TAI。按照随机数字表法将患者分为对照组80例、干预组80例。对照组给予常规护理,干预组给予常规护理和术前24 h内无创肢体远端缺血预处理干预3次。观察两组患者术后24 h内外周血管并发症及舒适度的差异。结果TAI术后12 h两组患者肿胀程度、疼痛程度差异有统计学意义(P<0.05)。TAI术后24 h内两组患者均未发生骨筋膜室综合征;两组患者桡动脉闭塞、局部出血发生情况比较差异无统计学意义(P>0.05);两组患者桡动脉狭窄、迷走神经反射发生情况比较差异有统计学意义(P<0.05)。结论无创肢体远端缺血预处理能有效减少TAI诊疗患者术后桡动脉狭窄等并发症的发生,提高患者术后的舒适度。

Objective To evaluate the effect of remote ischemic preconditioning on comfort level of patients after radial artery intervention.Methods A total of 160 patients with coronary heart disease were selected from the Second Ward of Cardiology Department of the First Affiliated Hospital of Xinjiang Medical University from June to December 2018 by convenience sampling method.All the patients underwent transradial angiography and intervention(TAI)and were randomly divided into the control group(80 cases)and the intervention group(80 cases).The control group received routine nursing care,while the intervention group received routine nursing care and remote ischemic preconditioning intervention for 3 times within 24 hours before surgery.The difference of vascular complications and comfort degree between the two groups within 24 hours after operation were compared.Results There was significant difference in the degree of swelling and pain between the two groups 12 hours after TAI(P<0.05).There was no osteofascial compartment syndrome in the two groups within 24 hours after Tai.There was no significant difference in the occurrence of radial artery occlusion and local bleeding between the two groups(P>0.05).There was significant difference in the occurrence of radial artery stenosis and vagal reflex between the two groups(P<0.05).Conclusions Remote ischemic preconditioning can effectively reduce the incidence of postoperative complications such as radial artery stenosis in patients undergoing coronary intervention via radial artery,and improve the postoperative comfort level of patients.