8字型弹力绷带与旋压式止血器对经桡动脉穿刺PCI术后患者的预后质量影响

摘要/Abstract

摘要： 目的探讨冠心病（Coronary Heart Disease,CHD）患者经桡动脉冠状动脉介入术（percutaneous coronary intervention,PCI）术后应用8字型弹力绷带与旋压式止血器的具体临床疗效,旨为患者后续治疗提供参考。方法选取2022年7月至2023年7月于我院进行诊治的300例行经桡动脉穿刺PCI的CHD患者作为研究对象,依据随机数字表法分为对照组（n=150）和实验组（n=150）;对照组患者术后给予旋压式止血器进行止血,实验组术后给予8字型弹力绷带进行止血。对比两组患者止血的有效性;比较两组患者术后腕围及术侧支端供氧情况;对比两组患者术后国际通用疼痛数字评级量表（numerical rating scale,NRS）的疼痛评估结果;比较两组患者不良反应、桡动脉狭窄及闭塞情况。结果与对照组比较,实验组血氧饱和度（Oxygen Saturation,SaO₂）[（95.31±5.96）% vs （97.38±6.63）%]明显升高（t=2.832,P=0.005）;与对照组比较,实验组术后渗血（14.00% vs 6.00%）、伤口血肿（12.67% vs 5.33%）、再次包扎（17.33% vs 7.33%）、术后腕围[（18.00±3.42）cm vs （16.02±3.36）cm]、无疼痛（68.00% vs 88.67%）、轻度疼痛（15.33% vs 6.67%）、中度疼痛（14.67% vs 4.67%）、肢体麻木（9.33% vs 3.33%）、肢体肿胀（10.67% vs 3.33%）、活动受限（14.00% vs 6.00%）、桡动脉狭窄及闭塞（6.00% vs 1.33%）明显更低（P<0.05或P<0.01）。结论 8字型弹力绷带对患者止血、不良反应、桡动脉狭窄及闭塞情况的改善作用均显著高于旋压式止血器,患者接受度更高,值得广泛推广。

关键词: 8字型弹力绷带, 旋压式止血器, 临床疗效, 止血效果, 并发症

Abstract: Objective To investigate the clinical effect of 8-shaped elastic bandage versus spinning hemostat in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) via radial artery puncture, and to provide a reference for subsequent treatment. Methods A total of 300 CHD patients who underwent PCI via radial artery puncture in The Third People’s Hospital of Nanning from July 2022 to July 2023 were enrolled as subjects, and they were divided into control group and experimental group using a random number table, with 150 patients in each group. The patients in the control group used a spinning hemostat after surgery, while those in the experimental group were given an 8-shaped elastic bandage for hemostasis. The two groups were compared in terms of the effect of hemostasis, postoperative wrist circumference, postoperative collateral oxygen supply, postoperative pain assessment based on numerical rating scale (NRS), adverse reactions, and radial artery stenosis/occlusion. Results Compared with the control group, the experimental group had a significant increase in blood oxygen saturation (95.31%±5.96% vs 97.38%±6.63%, t=2.832, P=0.005). Compared with the control group, the experimental group had a significantly lower proportion of patients with postoperative oozing bleeding (14.00% vs 6.00%), wound hematoma (12.67% vs 5.33%), or bandaging again (17.33% vs 7.33%) and a significantly smaller postoperative wrist circumference (18.00±3.42 cm vs 16.02±3.36 cm), with a P value of <0.05 or <0.01. Compared with the control group, the experimental group had a significantly higher proportion of patients with no pain (68.00% vs 88.67%) and a significantly lower proportion of patients with mild pain (15.33% vs 6.67%), moderate pain (14.67% vs 4.67%), limb numbness (9.33% vs 3.33%), limb swelling (10.67% vs 3.33%), limitation of motion (14.00% vs 6.00%), or radial artery stenosis/occlusion (6.00% vs 1.33%), with a P value of <0.05 or <0.01. Conclusion Compared with the spinning hemostat, the 8-shaped elastic bandage can better improve the effect of hemostasis, adverse reactions, and radial artery stenosis/occlusion and is more acceptable to patients; therefore, it holds promise for clinical application.

Key words: 8-Shaped elastic bandage, Spinning hemostat, Clinical effect, Hemostatic effect, Complication

周尔能, 王琼琼, 梁荣福, 谢立新, 韦远利, 陈丽妃. 8字型弹力绷带与旋压式止血器对经桡动脉穿刺PCI术后患者的预后质量影响[J]. 心血管病防治知识, 2024, 14(15): 3-7.

ZHOU Er-neng, WANG Qiong-qiong, LIANG Rong-fu, XIE Li-xin, WEI Yuan-li, CHEN Li-fei. Effect of 8-shaped elastic bandage versus spinning hemostat on treatment outcome, hemostatic effect, and complications in patients undergoing percutaneous coronary intervention via radial artery puncture[J]. Prevention and Treatment of Cardiovascular Disease, 2024, 14(15): 3-7.

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