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经皮冠状动脉腔内血管成形术后减少卧床时间(TIBS III)。

Reducing time in bed after percutaneous transluminal coronary angioplasty (TIBS III).

作者信息

Keeling A W, Fisher C A, Haugh K H, Powers E R, Turner M S

机构信息

University of Virginia School of Nursing, Charlottesville, USA.

出版信息

Am J Crit Care. 2000 May;9(3):185-7.

Abstract

BACKGROUND

This study is the third in a series of investigations on the requisite length of time that patients should be restricted to bed after coronary arteriography or percutaneous transluminal coronary angioplasty using a femoral artery approach.

METHODS

A prospective, experimental-control group design with randomization was used initially to compare the incidence of bleeding between patients who remained in bed for 4 hours and patients who remained in bed for 6 hours after sheath removal following percutaneous transluminal coronary angioplasty.

RESULTS

Rapid changes in the healthcare environment led to nurses collecting complete data sets for the experimental group only. The experimental group (n = 51) was 73% male and 27% female; mean age was 57 years (SD = 11.4 years). Mean time in bed was 4.1 hours (SD = 0.27 hours). Most patients (98%) did not bleed from the femoral artery access site after remaining in bed for 4 hours following sheath removal. Ninety-two percent of patients required analgesics while in bed. Mean length of stay after the angioplasty was 1.4 days (SD = 0.79 days). Bleeding occurred in one subject and was related to multiple invasive procedures and an activated clotting time of greater than 200 seconds.

CONCLUSIONS

Requisite time in bed after percutaneous transluminal coronary angioplasty has been reduced to 4 hours at the University of Virginia Medical Center, the same time required for patients undergoing cardiac catheterization. Discomfort after the procedure remains to be addressed.

摘要

背景

本研究是关于采用股动脉入路进行冠状动脉造影或经皮腔内冠状动脉成形术后患者需卧床的必要时长的系列调查中的第三项。

方法

最初采用前瞻性、随机实验对照组设计,比较经皮腔内冠状动脉成形术后拔鞘管后卧床4小时的患者与卧床6小时的患者的出血发生率。

结果

医疗环境的快速变化导致护士仅为实验组收集了完整数据集。实验组(n = 51)男性占73%,女性占27%;平均年龄为57岁(标准差 = 11.4岁)。平均卧床时间为4.1小时(标准差 = 0.27小时)。大多数患者(98%)拔鞘管后卧床4小时后股动脉穿刺部位未出血。92%的患者卧床期间需要使用镇痛药。血管成形术后的平均住院时间为1.4天(标准差 = 0.79天)。有1例患者发生出血,与多次侵入性操作及活化凝血时间大于200秒有关。

结论

在弗吉尼亚大学医学中心,经皮腔内冠状动脉成形术后的必要卧床时间已减至4小时,这与接受心导管检查的患者所需时间相同。术后不适问题仍有待解决。

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