体位及下肢加压制动对股静脉卵圆孔未闭封堵术后患者的应用价值

Study on the effects of body position and compression braking on lower limbs in patients with femoral vein patent foramen ovale after PFO blocking

目的研究经股静脉卵圆孔未闭(patent foramen ovale,PFO)封堵术后适宜地减小和解除压迫时间、术肢制动时间与术后并发症、护理满意度的关系。方法选择经股静脉PFO封堵的患者160例,随机分为对照组和观察组,每组80例。均使用股动脉压迫器止血。对照组采用常规护理措施,观察组术后2 h翻身活动肢体、缩短制动时间、减小压迫强度,比较2组患者的腰酸背痛、睡眠时间、穿刺部位出血血肿、术后并发症及护理满意度。结果2组穿刺点出血、局部血肿、下肢静脉血栓形成,差异无统计学意义(P>0.05),而观察组患者腰背疼痛、下肢肿胀麻木、睡眠障碍、尿潴留、术后医院滞留时间较对照组明显减少,护理满意度明显提高(P<0.05)。结论经股静脉PFO封堵患者,术后2 h翻身活动肢体、缩短制动和压迫时间、循序减小压迫强度,不会导致穿刺点出血和局部血肿的增加,而且能明显改善患者腰酸背痛、术肢麻木、尿潴留的发生,显著延长睡眠时间、提高护理满意率度、缩短患者术后医院滞留时间,值得临床推广。

Objective To investigate the correlation between the appropriate reduction and decompression time,the time of limb immobilization time and postoperative complications as well as nursing satisfaction degree of patients with femoral vein patent foramen ovale(PFO)after PFO blocking operation.Methods A total of 160 patients with femoral vein PFO who underwent PFO blocking in our hospital were randomly divided into control group and observation group,with 80 cases in each group.The femoral artery compression device was used to stop bleeding.After operation the patients in control group were treated by routine nursing measures,however,the patients in observation group began to turn over the active limbs at 2 hours after surgery to shortene the braking time and reduce the compression intensity.The back pain,sleep time,hemorrhage hematoma at the puncture site,postoperative complications and care satisfaction of patients were observed and compared between the two groups.Results There were no significant differences in puncture site bleeding,local hematoma and lower extremity venous thrombosis between the two groups(P>0.05).However,the incidence rates of back pain,lower extremity swelling and numbness,sleep disturbance,urinary retention and postoperative hospital stay in observation group were significantly less than those in control group,moreover the nursing satisfaction degree was significantly higher than that in control group(P<0.05).Conclusion The body position and compression braking on lower limbs in patients with femoral vein PFO undergoing PFO blocking operation can improve the limbs activity,shorten the braking and compression time,and reduce the compression intensity,withouting increasing puncture site bleeding and local hematoma,which can significantly decrease the incidence rates of back pain,numbness and urinary retention of the limbs,and can significantly prolong sleep time,improve the nursing satisfaction degree,and shorten the hospital stay after surgery.Thus it is worthy of clinical promotion.