改良低分子肝素注射方法对患者接受度及局部皮下出血影响的研究

目的 研究改良低分子肝索皮下注射方法与患者接受度、皮下出血发生率和出血面积的关系.方法 选择我科2008年1月-2010年1月住院需注射低分子肝素患者80例,随机分为常规改良注射组和常规注射组,各40例.改良组采用注射部位轮换及提捏方法,对照组采用传统注射法.对比观察患者自评接受度及注射部位皮下出血面积,并进行统计学分析.结果 改良组及常规组患者自评接受度分别为：很满意10、1人,满意26、18人,不满意4、21人;满意率分别为90%、47.5%,两组比较,P〈0.05,有统计学意义;改良组皮下出血5人,平均出血面积（0.016±0.022）cm^2,皮下出血率为12.5%;常规组皮下出血31人,平均出血面积（0.025±0.034）cm^2,皮下出血率为77.5%;两组比较,P〈0.05,有统计学意义.结论 改良低分子肝素皮下注射方法可明显增加患者接受度并减少皮下出血发生率及缩小出血面积.

Effect of modified low molecular weight heparin injection technique on patient acceptance and local subcutaneous hemorrhage

Objective To study the association of modified low molecular weight heparin ( LMWH )injection technique with patient acceptance and local subeutaneous hemorrhage. Methods 80 patients were randomly assigned to receive modified LMWH injection ( 40 patients, modified injection group ) or conventional injection (40 patients, conventional injection group ). The former group used different injection spots and raised pinches while the latter group used traditional injection technique. The self-assessed acceptance and the area of subcutaneous hemorrhage were compared and analyzed statistically. Results The selfassessed acceptance differed significantly between the modified injection group and the conventional group ( 10 vs 1 for much satisfaction, 26 vs18 for satisfaction, and 4 vs. 21 for dissatisfaction; P<0.05 ), with a satisfaction rate of 90%. 5 patients developed subcutaneous bleeding in the modred injection group, with an average hemorrhage area of ( 0.016 ± 0.022 ) cm2 and a hemorrhage rate of 12.5%; while 31 occurred bleeding in the conventional group, with an average hemorrhage area of ( 0.025 ± 0.034 ) cm2 and a hemorrhage rate of 77.5%. Conclusions The modified low molecular weight heparin injection technique can markedly increase patient acceptance, reduce the incidence of subcutaneous hemorrhage, and lessen the area of bleeding.