无创肢体缺血预适应对经桡动脉行择期PCI患者的影响

Influence of noninvasive limb ischemic preconditioning on patients undergoing transradial selective percutaneous coronary intervention

目的:观察无创肢体缺血预适应(NLIP)对经桡动脉行择期经皮冠状动脉介入术(PCI)患者的影响。方法:住院经桡动脉行择期PCI术的96例患者被随机均分为常规PCI组和NLIP组(在常规PCI基础上加用NLIP)。观察比较术前、后6h两组中指指根围度、前臂围度、数字疼痛评估法(NRS)评分和肢体肿胀程度,术后1d睡眠情况自评量表(SRSS)评分。结果:与常规PCI组比较,NLIP组术后6h中指指根围度[(70.85±4.99)mm比(67.56±8.00)mm]、前臂围度[(28.91±3.34)cm比(25.79±1.97)cm]、疼痛NRS评分[(3.73±0.71)分比(2.83±1.68)分]显著降低,轻度肢体肿胀比例(37.5%比72.9%)显著升高,P<0.05或<0.01;术后1d的SRSS评分[(38.27±4.82)分比(31.63±4.27)分]显著降低,P=0.001。结论:无创肢体缺血预适应可显著降低经桡动脉路径行择期PCI患者术后肢体肿胀、疼痛程度和改善睡眠质量,进而促进患者快速康复。

Objective:To observe influence of noninvasive limb ischemic preconditioning(NLIP)on patients undergoing transradial percutaneous coronary intervention(PCI).Methods:A total of 96 inpatients undergoing transradial selective PCI were randomly and equally divided into routine PCI group and NLIP group(received NLIP based on routine PCI).Middle finger root girth,forearm girth,numeric rating scale(NRS)for pain and limb swelling extent before and 6h after PCI,score of self-rating scale of sleep(SRSS)before and 1d after PCI were observed and compared between two groups.Results:Compared with routine PCI group,on 6h after PCI,there were significant reductions in middle finger root girth[(70.85±4.99)mm vs.(67.56±8.00)mm],forearm girth[(28.91±3.34)cm vs.(25.79±1.97)cm]and NRS for pain score[(3.73±0.71)scores vs.(2.83±1.68)scores],and significant rise in percentage of mild limb swelling(37.5%vs.72.9%),P<0.05 or<0.01;and significant reduction in SRSS score[(38.27±4.82)scores vs.(31.63±4.27)scores]on 1d after PCI in NLIP group,P=0.001.Conclusion:Noninvasive limb ischemic preconditioning can significantly relieve postoperative limb swelling,pain and improve sleep quality,then promote rapid rehabilitation in patients undergoing transradial selective PCI.