循证护理结合PDCA循环管理法在降低经皮冠状动脉介入治疗术后腹部皮下注射低分子肝素局部不良反应的应用效果

Evidence-based nursing combined with PDCA circulatory management method in reducing the local adverse reactions of subcutaneous injection of low molecular weight heparin after percutaneous coronary intervention

目的探讨PDCA循环管理法结合循证护理在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后应用低分子肝素皮下注射降低局部出血的应用效果。方法选取2018年1月至2018年6月河北医科大学第一医院收治的60例PCI术后皮下注射低分子肝素的患者,随机分为观察组和对照组,各30例。患者每12h注射1次,7天为一个疗程。两组患者在同样的常规护理下,实验组运用PDCA循环管理结合循证护理注射低分子肝素,比较两组皮下出血发生率、疼痛程度及护理操作满意度。结果两组均未发现皮下硬结。观察组瘀斑发生率[6.7%(2/30)比23.3%(7/30)],局部疼痛发生率[6.7%(2/30)比73.3%(22/30)]显著低于对照组,差异均有统计学意义(均P<0.05)。结论 PDCA循环管理法结合循证护理,可明显降低PCI术后腹部皮下注射低分子肝素患者局部的瘀斑、疼痛发生率,减轻患者痛苦,提高患者对护理操作的满意度。

Objective To observe the application effect of PDCA circulation management combined with evidence-based nursing to reduce local hemorrhage after subcutaneous injection of low molecular weight heparin after PCI.Methods From January 2018 to June 2018,60 patients with subcutaneous injection of low-molecular-weight heparin who were treated in the heart of a hospital were randomly divided into observation group and control group,30 cases each.Patients were injected once every 12 hours and 7 days were taken as a course of treatment to obtain 420 samples.Under the same routine care,the experimental group used PDCA cycle management combined with evidence-based care and injection of low molecular weight heparin to compare the incidence of subcutaneous hemorrhage between the two groups,pain level and satisfaction with nursing operations.Results There were 8 cases of subcutaneous ecchymosis,17 cases of local pain,and 6% of ecchymosis in the observation group.35 cases of ecchymosis,84 cases of pain,and 16.6% of ecchymosis occurred after injection in the control group.Adverse reactions in the observation group were observed.The incidence was significantly lower than that in the control group.The difference was statistically significant(P<0.05).Conclusion PDCA circulation management combined with evidence-based nursing can significantly reduce the incidence of freckle,pain,and pain in patients with low molecular weight heparin after PCI.