May Ole, Schlosser Helle, Skytte Lene
Department of Medicine, Region Hospital Herning, Herning, Denmark.
J Interv Cardiol. 2008 Aug;21(4):347-9. doi: 10.1111/j.1540-8183.2008.00359.x. Epub 2008 May 29.
The aim of the study was to examine whether moving during a 2-hour observation period in bed after coronary angiography was associated with a higher incidence of bleeding complications compared to a standard regimen, where the patients were told not to move. In both regimens a 4.5 kg sandbag 25 x 12 x 12 cm was placed over the puncture site along the inguinal ligament for the first hour. The sandbag prevented the patients from turning over, but did not prevent bending in the hip and knee. We consecutively included 1,000 patients scheduled for elective diagnostic coronary angiography using the femoral approach. The in-hospital incidence of hematoma > or =5 cm was 7%. No statistical difference was detected between the two regimens regarding the incidence of bleeding or hematoma formation. The patients preferred the alternative regimen and fewer patients in the alternative regimen had back pain as well as pain from the puncture site. We conclude that patients should not be told to lie still during the observation period after coronary angiography.
本研究的目的是检验冠状动脉造影术后在2小时卧床观察期内活动与标准方案（告知患者不要活动）相比是否会导致更高的出血并发症发生率。在两种方案中，第一个小时均在穿刺部位沿腹股沟韧带放置一个4.5千克、25×12×12厘米的沙袋。沙袋防止患者翻身，但不防止髋部和膝部弯曲。我们连续纳入了1000例行择期诊断性股动脉途径冠状动脉造影的患者。院内血肿≥5厘米的发生率为7%。两种方案在出血或血肿形成发生率方面未检测到统计学差异。患者更喜欢替代方案，且替代方案中背痛以及穿刺部位疼痛的患者更少。我们得出结论，冠状动脉造影术后观察期不应告知患者静卧不动。
