微量泵注入肝素液对应用IABP患者的影响

Effect of heparin injection by micro injection pump on complications in patients treated with IABP WU Tengqing,

目的 观察微量注射泵注入肝素液对应用主动脉内球囊反搏(IABP)患者的影响。方法 选取2011年4月—2014年7月桂东人民医院心血管内科接受IABP治疗患者50例,采用IBM SPSS 10.0软件随机分为观察组和对照组,每组25例。对照组采用传统方法,每1小时使用肝素盐水(浓度25 U/ml)加压冲洗中央腔1次,每次>15 s,2~3 ml。观察组改用微量注射泵注入肝素盐水(浓度25 U/ml),以2~3 ml/h匀速冲洗中央腔。比较2组患者管路堵塞、出血、血肿、下肢缺血、血栓形成发生率,患者干预前后相关生理指标(心率、平均动脉压、反搏压)及凝血指标[血小板计数(PLT)、活化部分凝血活酶时间(APTT)、国际标准化比率(INR)]变化,护理人员对操作满意度。结果 2组患者的管路堵塞、出血、血肿、下肢缺血、血栓形成发生率比较差异无统计学意义(P>0.05);2组患者采用不同的冲洗方法干预前后各参数及血凝结果比较差异无统计学意义(P>0.05);观察组护理人员对操作总满意度高于对照组,差异有统计学意义(χ^(2)=4.735,P=0.022)。结论 微量注射泵注入肝素盐水(浓度25 U/ml),以2~3 ml/h的匀速冲洗中央腔,不引起患者生命体征变化,也不影响患者血凝结果,不增加患者并发症发生,能减轻护士工作量,提高工作效率和护理人员满意度。

Objective To observe the effect of heparin injection by micro injection pump on the complications of patients treated with IABP. Methods Fifty patients who received IABP in the Department of Cardiovascular Medicine of Guidong People’s Hospital of Guangxi Zhuang Autonomous Region from April 2011 to July 2014 were randomly divided into observation group and control group by IBM SPSS 10. 0 software,with 25 cases in each group. In the control group,heparin saline( concentration 25 U/ml) was used to flush the central cavity once every hour,each time > 15 s,2 ~ 3 ml. In the observation group,heparin saline( concentration 25 U/ml) was injected with a micro injection pump,and the central cavity was washed at a uniform speed of 2 ~ 3 ml/h. The incidence of pipeline blockage,bleeding,hematoma,lower limb ischemia and thrombosis,the changes of relevant physiological indexes( heart rate,mean arterial pressure,counterpulsation pressure) and coagulation indexes( PLT,APTT,INR) before and after intervention,and the satisfaction of nurses with the operation were compared between the two groups. Results There was no significant difference in the incidence of pipeline blockage,bleeding,hematoma,lower limb ischemia and thrombosis between the two groups( P > 0. 05);There was no significant difference in parameters and hemagglutination results between the two groups before and after different flushing methods( P > 0. 05);The satisfaction of nurses in the observation group was higher than that in the control group,the difference was statistically significant( χ^(2)= 4. 735,P = 0. 022). Conclusion The microinjection pump injects heparin saline( concentration 25 U/ml) and flushes the central cavity at a uniform speed of 2 ~ 3 ml/h. This operation will not cause changes in the vital signs of the patient,will not affect the hemagglutination results of the patient,and will not increase the incidence of complications.However,this operation can reduce nurses’ workload,improve work efficiency and nurses’ satisfaction with the operation.