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冠状动脉造影患者早期活动的效果:以血管并发症和背痛为重点的初步研究。

The effect of early mobilisation for patient undergoing coronary angiography; a pilot study with focus on vascular complications and back pain.

机构信息

Department of Cardiology, Linköping University Hospital, Linköping, Sweden.

出版信息

Eur J Cardiovasc Nurs. 2011 Jun;10(2):130-6. doi: 10.1016/j.ejcnurse.2010.05.005. Epub 2010 Jul 9.

Abstract

BACKGROUND

The optimal length of bed rest after femoral coronary angiography is still unknown. Short immobilisation could cause puncture site complications due to the modern antiplatelet therapy used, while long immobilisation time increases the risk of back pain for the patient.

PURPOSE

To assess the safety, as well as perceived comfort, of early mobilisation after coronary angiography with femoral approach.

METHODS

A randomised, single centre pilot trial with 104 coronary angiography patients (including 58 patients with non ST-elevation acute coronary syndrome) assigned to a post-procedural bed rest time for either 1.5 or 5 h. The primary endpoint was any incidence of vascular complication. Patients' discomfort was measured as self-perceived grade of pain in the back.

RESULTS

The presence of haematomas ≥ 5 cm was 5.8% in the short immobilisation group vs. 3.8% in the control group (ns). There was a significantly lower rate of perceived back pain in the short immobilisation group, compared to the controls, at the time of mobilisation, which remained significant also after 2 h of mobilisation.

CONCLUSION

Early ambulation after coronary angiography is safe, without affecting the incidence of vascular complications, and decreases the patients' pain, both during and after the bed rest.

摘要

背景

股动脉冠状动脉造影后卧床休息的最佳时间仍不清楚。由于现代抗血小板治疗的应用,短时间固定可能会导致穿刺部位并发症,而长时间固定会增加患者背痛的风险。

目的

评估经股动脉冠状动脉造影后早期活动的安全性和舒适度。

方法

一项随机、单中心的初步试验,纳入 104 例冠状动脉造影患者(包括 58 例非 ST 段抬高型急性冠状动脉综合征患者),分为术后卧床 1.5 小时或 5 小时两组。主要终点是血管并发症的任何发生率。患者的不适程度通过背部自我感知疼痛程度来衡量。

结果

在短时间固定组中,血肿≥5cm 的发生率为 5.8%,而对照组为 3.8%(无统计学意义)。与对照组相比,短时间固定组在活动时的背部疼痛感知率明显较低,在活动后 2 小时仍保持显著差异。

结论

冠状动脉造影后早期活动是安全的,不会影响血管并发症的发生率,并可减轻患者在卧床休息期间和之后的疼痛。

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