简体中文

·骨肌疾病·

大号腕部支具在经肱动脉介入术后上肢制动中的应用

作者:丁美幸 郭向华 洪碧云

所属单位:河南理工大学第一附属医院(焦作市第二人民医院)心血管内科 (河南 焦作 454000)

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摘要

目的 探讨大号腕部固定支具应用于经肱动脉冠状动脉介入术后上肢制动的效果。方法 选取2012-2016年经肱动脉 冠状动脉介入术的50例病人,分为对照组和实验组各25例, 对照组介入术后, 拔出鞘管,压迫穿刺处止血,然后用 绷带环形加压包扎穿刺点,肘关节制动8小时,8小时后拆除绷带。实验组同样方法加压包扎穿刺点后,将患者穿刺 侧上肢以肘关节为中心置入制动支具内,根据患者臂围调节支具的松紧度,8小时后拆除支具和绷带。结果 两组的 舒适度、焦虑程度有明显的统计学差异(P<0.05)。结论 大号腕部固定支具应用于经肱动脉冠状动脉介入术后的上 肢制动,提高了患者的舒适度,减轻了患者的焦虑程度,提高了患者的遵医行为,减少了穿刺处出血血肿的并发 症。

Objective To investigate the effect of large-scale wrist fixation brace on brachial artery brachial artery intervention. Methods Fifty patients with brachial artery coronary intervention were divided into control group and experimental group. Twenty-five patients were divided into control group and experimental group. In the control group, the sheath was pulled out and the puncture was stopped. Then, Pressure bandage puncture point, elbow brake 8 hours, 8 hours after the removal of the bandage. The same method of the experimental group after compression banding puncture point, the patient's puncture side of the upper limb to the elbow as the center into the brake brace, according to the patient's arm to adjust the tightness of the brace, 8 hours after the removal of braces and bandages. Results There were significant differences in the degree of comfort and anxiety between the two groups (P<0.05). Conclusion The large wrist fixation is applied to the brachial brachial artery brachial arterial intervention, which improves the patient's comfort, reduces the anxiety of the patients, improves the patient's compliance behavior and reduces the bleeding Hematoma complications.

【关键词】固定支具;肱动脉;制动

【中图分类号】R608;R445.4

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2017.06.020

前言

近年来冠状动脉介入诊疗经桡动脉途径以其微 创、并发症少、痛苦小等优点,已被用作大部分患者 的常规径路[1]。但由于桡动脉内径相对较细小,穿刺 成功率偏低且易发生痉挛[2],经股动脉途径的穿刺部 位并发症较多且术后需患者卧床限制活动;而肱动脉 较桡动脉粗大,穿刺相对容易,穿刺成功率高,且术 后患者无需体位限制,因此,经肱动脉途径为更好入 路[1]。但经皮肱动脉冠状动脉介入术后,常采用绷带 加压止血法对穿刺处进行止血.需要上肢伸直肘部制 动不能弯曲,并受压8小时。患者处于过度紧张、焦 虑状态。感觉舒适度明显降低,且注意力多集中于疼 痛的穿刺处,影响休息睡眠,从而影响患者对相关护理措施或健康教育的理解与配合度,导致肘部弯曲, 发生上肢肿胀、局部出血血肿等并发症。我科自2012 年起,将大号腕部固定支具应用于经肱动脉冠状动脉 介入术后的上肢制动,减轻了患者的焦虑程度,增加 了患者的舒适度,提高了患者的配合度,减少了术后 并发症的发生。