个体化减压联合术肢康复运动在冠心病经皮冠状动脉介入术患者中的应用效果

目的 探讨个体化减压联合术肢康复运动在冠心病经皮冠状动脉介入术(percutaneous coronary intervention,PCI)患者中的应用效果。方法 采用便利抽样法,选取江西省某三级甲等综合性医院心内科住院的经桡动脉入路行PCI治疗的冠心病患者360例,按所在病区分为对照组和观察组,各180例。对照组给予常规术后减压,并引导患者完成伸肘屈肘、松握拳头等动作;观察组根据患者个体化情况调节止血器减压,并指导其进行术肢康复操运动,比较2组术肢疼痛、肿胀、焦虑和穿刺点出血情况。结果 观察组术后4 h和12 h疼痛程度均轻于对照组(Z＝-2.096,P=0.036;Z＝-3.791,P＜0.001);术后1 h、4 h和12 h局部肿胀程度均轻于对照组(Z＝-2.373,P=0.018;Z＝- 2.045,P=0.041;Z=-2.834,P=0.005);术后4 h和12 h焦虑得分均低于对照组(t＝2.813,P=0.038;t＝2.644,P=0.009);2组术后24 h内穿刺局部出血情况比较,差异无统计学意义(Z=-0.891,P=0.763 )。结论 个体化的减压方法与肢体康复运动相结合,不仅能减轻患者疼痛和肿胀,还可改善患者的焦虑情绪,且不会增加出血的风险,值得临床推广应用。

Application of individualized decompression combined with limb rehabilitation exercise in patients with coronary heart disease after PCI via radial artery

Objective To explore the effect of individual decompression combined with limb rehabilitation exercise on patients with coronary heart disease (CHD) after percutaneous transluminal coronary intervention (PCI) via radial artery. Methods A total of 360 CHD patients undergoing PCI via radial artery were selected from two wards in the department of Cardiology of a class-3 grade-A hospital of Jiangxi province, and divided into a control group(n=180) and an observation group(n=180) according to their different wards. The control group was given routine postoperative decompression methods, and taught how to stretch and withdraw elbows, clench and unclench fists. The observation group was given individualized hemostatic decompression and rehabilitation guidance. The pain, swelling, anxiety and bleeding of the two groups were compared. Results The pain degree of the observation group was lighter than that of the control group at 4h and 12h after operation(Z=-2.096,P=0.036; Z=-3.791,P<0.001). The local swelling at 1h, 4h and 12h after operation in the observation group was less severe than that in the control group (Z=-2.373,P=0.018; Z=-2.045,P=0.041; Z=-2.834,P=0.005). The anxiety scores at 4h and 12h after operation of the former were lower than the latter(t=2.813,P=0.038; t=2.644,P=0.009). There was no statistical significance between the two groups(Z=-0.891,P=0.763). Conclusion The combination of individualized decompression and limb rehabilitation exercise can not only reduce the pain and swelling of hands, but also relieve the anxiety symptoms of patients, without increasing the risk of bleeding. Therefore, such treatment is worthy of promotion in the clinical practice.