Moeini Mahin, Moradpour Fatemeh, Babaei Sima, Rafieian Mohsen, Khosravi Alireza
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2010 Summer;15(3):109-14.
During the last 3 decades, there were increasing tendency towards angioplasty because of its benefits. But, this procedure has its acute problems like bleeding and formation of hematoma in the removal place of the sheet. Based on researchers' clinical experiences, patients need a time of 8-12 hours for bed rest after coronary angioplasty. Recognizing desirable time for bed rest after angioplasty and remove the arterial sheet forms the foundation of related researches in the world. Getting out of bed soon after angioplasty, causes more comfortable feelings, less hospitalization period, fewer side effects of prolonged bed rest and less hospitalization expenses. Regarding less time for bed rest after angioplasty, the aim of this study was to assess the effect of the time of getting out of bed after angioplasty on the complications after removing the sheet in coronary angioplasty patients.
This was an experimental clinical study conducted in one step and two groups. Samples were included 124 angioplasty patients (62 in each group) who were chosen randomly from the CCU of Shahid Chamran hospital of the Isfahan University of Medical Sciences in 2007. Data were gathered by observing and evaluating the patients, using a questionnaire and a checklist. After angioplasty, patients from the intervention group were taken out of bed in 4 hours and patients from the control group were taken out of bed in 8 hours. After taking out of bed, patients were examined for bleeding and formation of hematoma in the place of taking out the arterial sheet. Data were analyzed using descriptive and inferential statistics via SPSS software.
Results showed no meaningful difference between the two groups after getting out of bed (p > 0.05) regarding relative frequency of bleeding (p = 0.50), formation of hematoma (p = 0.34) and average diameter of hematoma (p = 0.39).
Results of this study showed that reducing the bed rest time to 4 hours after removing the arterial sheet of size 7 do not increase bleeding and formation of hematoma in the removal place of the sheet. So, those angioplasty patients who do not have critical clinical condition and their vital symptoms are stabilized will be able to get out of bed 4 hours after removing the sheet.
在过去30年中，由于血管成形术的益处，其应用趋势不断增加。但是，该手术存在一些急性问题，如出血以及在拔除鞘管部位形成血肿。根据研究人员的临床经验，冠状动脉血管成形术后患者需要8至12小时的卧床休息时间。确定血管成形术后理想的卧床休息时间并拔除动脉鞘管是全球相关研究的基础。血管成形术后尽早下床可带来更舒适的感觉、缩短住院时间、减少长期卧床的副作用以及降低住院费用。鉴于血管成形术后卧床休息时间较短，本研究的目的是评估血管成形术后下床时间对冠状动脉血管成形术患者拔除鞘管后并发症的影响。
这是一项单步两组的实验性临床研究。样本包括2007年从伊斯法罕医科大学沙希德·查姆兰医院冠心病监护病房随机选取的124例血管成形术患者（每组62例）。通过观察和评估患者、使用问卷和检查表收集数据。血管成形术后，干预组患者在4小时后下床，对照组患者在8小时后下床。下床后，检查患者拔除动脉鞘管部位的出血和血肿形成情况。通过SPSS软件使用描述性和推断性统计分析数据。
结果显示，两组患者下床后在出血相对频率（p = 0.50）、血肿形成（p = 0.34）和血肿平均直径（p = 0.39）方面无显著差异（p > 0.05）。
本研究结果表明，拔除7号动脉鞘管后将卧床休息时间缩短至4小时不会增加鞘管拔除部位的出血和血肿形成。因此，那些没有严重临床状况且生命体征稳定的血管成形术患者在拔除鞘管4小时后即可下床。
