Botti M, Williamson B, Steen K
Deakin University School of Nursing, Victoria, Australia.
Heart Lung. 2001 Mar-Apr;30(2):138-45. doi: 10.1067/mhl.2001.114192.
The purposes of this study were to describe the incidence and occurrence of femoral artery bleeding during the first 6 hours after coronary angiography and to determine whether there is a relationship between current postangiogram observation protocols and the detection of complications.
This was a prospective descriptive study.
The study was conducted in 3 university hospitals in Melbourne, Australia.
Subjects included 55 patients representing the complication rate of 1075 patients, mean age 61 years (SD, 12), 69% male.
About 5.1% of patients had 1 or more incidents of bleeding requiring manual compression. In 4.2% of patients, bleeding occurred within 6 hours of angiography. Bleeding occurred a median of 2.02 hours (Q1 = 45 minutes, Q3 = 4.31 hours) after angiography. Patients without pressure bandaging bled a median of 1.32 hours (Q1 = 36.50 minutes, Q3 = 2.59 hours) after angiography. Patients with pressure bandaging bled a median of 4.75 hours (Q1 = 2.25 hours, Q3 = 7.28 hours) after angiography. In 40.6% of cases, bleeding was detected through the patient's call for assistance, and in 59.4% of cases nurses noted bleeding while checking the puncture site. Postcatheter observations were recorded 23.70 (SD, 14.60) minutes before the bleeding incident. There were no significant changes in vital signs, systolic blood pressure (P >.05), diastolic blood pressure (P >.05), or pulse (P >.05) before or during a bleeding episode. All were within normal parameters. No neurovascular assessment anomalies were detected.
The use of pressure bandaging has a significant effect on the incidence and pattern of bleeding. Routine vital sign measurement has no relevance in detecting local complications after angiography. The most significant complication is bleeding that requires manual compression. Detection is through frequent puncture site observation and patient recognition and communication.
本研究的目的是描述冠状动脉造影术后最初6小时内股动脉出血的发生率和发生情况，并确定当前造影后观察方案与并发症检测之间是否存在关联。
这是一项前瞻性描述性研究。
该研究在澳大利亚墨尔本的3家大学医院进行。
研究对象包括55名患者，代表了1075名患者的并发症发生率，平均年龄61岁（标准差12岁），男性占69%。
约5.1%的患者发生1次或更多次需要手动压迫的出血事件。4.2%的患者在血管造影后6小时内出血。出血发生在血管造影后的中位时间为2.02小时（第一四分位数 = 45分钟，第三四分位数 = 4.31小时）。未进行加压包扎的患者在血管造影后的中位出血时间为1.32小时（第一四分位数 = 36.50分钟，第三四分位数 = 2.59小时）。进行加压包扎的患者在血管造影后的中位出血时间为4.75小时（第一四分位数 = 2.25小时，第三四分位数 = 7.28小时）。在40.6%的病例中，出血是通过患者呼救被发现的，在59.4%的病例中，护士在检查穿刺部位时发现出血。在出血事件发生前23.70（标准差14.60）分钟记录了导管后置观察情况。在出血事件发生前或期间，生命体征、收缩压（P>.05）、舒张压（P>.05）或脉搏（P>.05）均无显著变化。所有指标均在正常范围内。未检测到神经血管评估异常。
加压包扎的使用对出血的发生率和模式有显著影响。常规生命体征测量与血管造影后局部并发症的检测无关。最显著的并发症是需要手动压迫的出血。通过频繁观察穿刺部位以及患者的识别和沟通来进行检测。
