早期减压对经远端桡动脉行冠状动脉介入术患者的安全性

Safety of Early Decompression in Patients Undergoing Coronary Intervention via Distal Radial Artery

目的探讨经远端桡动脉行冠状动脉介入术后不同时间减压的安全性。方法选取2022年12月—2023年12月在南京医科大学第一附属医院心血管内科经远端桡动脉入径行冠状动脉造影介入治疗的139例患者作为研究对象,采用随机数字表法分为三组。A组47例,术后30 min首次减压;B组47例,术后1 h首次减压;C组45例,术后2 h首次减压。比较各组术后即刻、30 min、1 h、2 h、4 h术侧肢体疼痛评分、舒适度评分、手掌周径肿胀率及术后穿刺处出血情况。结果术后即刻各组的疼痛评分、舒适度评分及手掌周径肿胀率比较,差异均无统计学意义(P>0.05),A组术后30 min、1 h、2 h、4 h的肢体疼痛评分低于B组与C组(P<0.05),舒适度评分高于B组与C组(P<0.05);A组在术后1 h、2 h、4 h的手掌肿胀率低于B组与C组(P<0.05);各组术后穿刺处出血情况比较,差异均无统计学意义(P>0.05)。结论经远端桡动脉行冠状动脉介入术的患者采用术后30 min首次减压安全有效,且可显著缓解疼痛、肿胀不适感,提高舒适度,值得在临床工作中推广。

Objective To investigate the safety of different time decompression in patients undergoing coronary intervention via distal radial artery.Methods From December 2022 to December 2023,a total of 139 patients undergoing coronary intervention through distal radial artery in the department of cardiovascular medicine of the First Affiliated Hospital of Nanjing Medical University were selected and divided into three groups by the random number table method.Group A,47 cases,underwent first decompression 30 minutes after operation.Group B,47 cases,underwent initial decompression 1 h after operation.Group C,45 cases,underwent initial decompression 2 h after operation.Postoperative limb pain score,comfort score and palm-diameter swelling rate immediately after operation,30 min,1 h,2 h and 4 h,and postoperative puncture bleeding were compared among the three groups.Results Immediately after operation,the pain score,comfort score and the swelling rate of the circumference of the palm among the three groups showed no statistical significance(P>0.05).The limb pain score of group A at 30 min,1 h,2 h and 4 h after operation was lower than that in group B and group C(P<0.05),and the comfort score was higher than that in group B and group C(P<0.05).The swelling rate of the palms of group A at 1 h,2 h and 4 h after operation was lower than that in group B and group C(P<0.05).There was no significant difference in postoperative bleeding among the three groups(P>0.05).Conclusion The first decompression within 30 minutes after operation is safe and effective for patients undergoing coronary intervention through distal radial artery,which can significantly relieve pain,swelling discomfort and improve comfort,and is worthy of promotion in clinical work.