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冰敷止痛法治疗桡动脉血气分析穿刺疼痛的效果分析

作者:杨彦萍 秦 婷 关丽丽 唐莹莹

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)心血管内科二区 (河南 焦作 454001)

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摘要

目的 探究冰敷止痛法治疗桡动脉血气分析穿刺疼痛的效果。方法 将2016年6月-2017年4月于我院行桡动脉血气分 析穿刺的患者60例按照随机数表法分为观察组(n=30)和对照组(n=30),对照组患者采用常规桡动脉穿刺取血,不使 用疼痛干预措施,观察组患者常规桡动脉穿刺取血前使用冰敷止痛法冰敷桡动脉穿刺部位,比较两组止痛效果、穿 刺前后心率变化和护理满意度。结果 观察组止痛总有效率(85.00%)显著高于对照组(65.00%),差异具有统计学意 义(χ2 =4.267,P=0.039);对照组穿刺后心率(96.14±15.32)次/分与穿刺前(89.15±12.14)次/分比较显著上升, 差异具有统计学意义(t=2.262,P=0.027);观察组穿刺后心率(92.21±12.56)次/分与穿刺前(90.18±10.92)次/分 比较无显著差异(t=0.771,P=0.443);观察组护理总满意度(95.00%)显著高于对照组(60.00%),差异具有统计学意 义(χ2 =14.050,P<0.001)。结论 桡动脉血气分析穿刺前使用冰敷止痛法可以显著减轻患者穿刺疼痛,降低局部组 织神经敏感性,显著提高患者护理满意度,保证血气分析结果的准确性,为临床治疗提供可靠依据。

Objective To explore the effect of ice compress analgesia on radial artery puncture pain of blood gas analysis. Methods From Jun. 2016 to Apr. 2017, 60 patients with radial artery puncture for blood gas analysis in our hospital were randomly divided into observation group (n=30) and control group (n=30). Patients in the control group were given routine radial artery puncture and no pain intervention measures were used, but the other patients in observation group were given ice compress on puncture site before radial artery puncture. The analgesic effects, heart rate changes before and after puncture, and nursing satisfaction were compared between the two groups. Results The total effective rate of analgesia in the observation group was 85% which was significantly higher than that in the control group 65%, and their difference was statistically significant (χ2 =4.267, P=0.039), after puncture, the heart rate in the control group was (96.14±15.32) times/min which was significantly higher than that before puncture (89.15±12.14) times/ min, the difference was statistically significant (t=2.262, P=0.027); the heart rate in observation after the puncture was(92.21±12.56) times/min which was higher than that before puncture (90.18±10.92) times/min, but the difference was not statistically significant (t=0.771, P=0.443), the nursing satisfaction degree in the observation group was 95% which was significantly higher than that in the control group 60%, the difference was statistically significant (χ2 =14.050, P<0.001). Conclusion Ice compress analgesia can significantly reduce patients' radial artery puncture pain for blood gas analysis, reduce local nerve tissue sensitivity, improve nursing satisfaction degrees, ensure the accuracy of blood gas analysis results, and provide a reliable basis for clinical treatment.

【关键词】冰敷止痛法;桡动脉;穿刺;疼痛

【中图分类号】R322.1+21

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2018.01.031

前言

动脉血气分析能客观反映呼吸、循环功能状态和 酸碱平衡,是判断患者有无缺氧和二氧化碳潴留的临 床常用方法,对指导氧疗、调节机械通气参数以及纠 正酸碱和电解质失衡具有重要意义[1]。临床上常选用 桡动脉穿刺采集动脉血标本做血液气体分析,但由于桡动脉穿刺属于创伤性治疗,术后局部包扎阻碍静 脉血液回流,可导致患者穿刺部位肿胀、渗血[2]。因 此,为减轻患者术后疼痛,本研究以我院60例行桡动 脉血气分析穿刺的患者为研究对象,取得了良好的效 果,现报道如下。