不同性别老年患者行冠脉造影术后发生穿刺侧肢体症状的差异性研究

Study on the difference of puncture side limb symptoms in elderly patients of different genders after coronary angiography

目的探讨不同性别老年患者行冠脉造影术后发生穿刺处肢体症状的差异。方法选择福建医科大学附属协和医院2020年7月至12月连续收治的398例老年冠心病患者作为研究对象,根据性别不同分为男性组214例及女性组184例,患者均行冠状动脉造影手术,比较穿刺侧肢体症状的差异。结果女性组与男性组数据比较分别为:术后2小时的疼痛评分(3.51±1.33)分与(2.31±1.21)分、手术前后掌中周长差值(0.62±0.25)cm与(0.48±0.36)cm、穿刺侧肢体瘀斑发生率12%与3.7%、穿刺处渗血率11.4%与5.6%,以上差异均明显(P<0.05)。低体重指数的老年女性患者组的穿刺处肢体症状表现得尤其明显,疼痛评分为(5.0±0.2)分、手术前后掌中周长差值为(0.89±0.04)cm,穿刺处渗血率22.9%,穿刺处血管闭塞率为14.3%。结论老年女性患者行冠脉造影术后出现穿刺侧肢体症状较老年男性患者明显,低体重指数的老年女性患者行冠脉造影术后发生穿刺处肢体症状的情况尤其明显,应加强对老年低体重女性患者冠脉造影术前术后管理。

Objective To investigate the differences in limb symptoms at the puncture site in elderly patients of different genders after coronary angiography.Methods The 398 elderly patients with coronary heart disease who were continuously admitted to the Union Hospital of Fujian Medical University from July 2020 to December 2020 were selected as the research objects.According to different genders,they were divided into 214 cases in male group and 184 cases in female group.All patients underwent coronary angiography,and the differences in limb symptoms at the puncture site were compared.Results The comparison of the data between the elderly female patient group and the elderly male patient group were:pain score(3.51±1.33)VS(2.31±1.21)at 2 hours after surgery,and the difference in palm circumference before and after surgery(0.62±0.25)cm VS(0.48±0.36)cm,the incidence of limb ecchymosis on the side of the puncture 12%VS 3.7%,and the rate of bleeding at the puncture site 11.4%VS 5.6%.The above differences were significant(P<0.05);in the elderly In the analysis of female subgroups,elderly female patients with low body mass index showed particularly obvious physical symptoms at the puncture site,their pain score was(5.0±0.2),and the difference in palm circumference before and after the operation was(0.89±0.04)cm,oozing blood at the puncture site The rate was 22.9%,and the rate of vascular occlusion at the puncture site was 14.3%.Conclusion Elderly female patients with coronary angiography have more obvious symptoms on the side of the puncture than male patients;elderly female patients with low body mass index have more obvious symptoms at the side of the puncture after coronary angiography;Strengthen the preoperative,intraoperative and postoperative management of elderly low-weight female patients with coronary angiography.