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卧床时间对先天性心脏病患儿心脏导管术后血管并发症的影响:一项随机对照试验。

Effects of time of bed rest on vascular complications after cardiac catheterization in pediatric patients with congenital heart disease: A randomized controlled trial.

机构信息

Department of Nursing, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, South Korea.

Department of Nursing, Cardiac Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, South Korea.

出版信息

Heart Lung. 2023 Jul-Aug;60:52-58. doi: 10.1016/j.hrtlng.2023.02.023. Epub 2023 Mar 11.

DOI:10.1016/j.hrtlng.2023.02.023
PMID:36913902
Abstract

BACKGROUND

Pediatric cardiac catheterization, which is performed by accessing the femoral vessel, requires immobilization and bed rest for 4-6 h to prevent vascular complications. Studies in adults suggest that the immobilization time for the same access can be safely reduced to approximately 2 h after catheterization. However, it is unclear whether bed-rest time can be safely decreased after catheterization in children.

OBJECTIVE

To assess the effects of bed-rest duration on bleeding, vascular complications, pain level, and the use of additional sedatives after transfemoral cardiac catheterization in children with congenital heart disease.

METHODS

This study was an open-label, randomized, controlled, posttest-only design, including 86 children who underwent cardiac catheterization. Children were allocated to receive either 2 h of bed rest (n = 42) in the experimental group or 4 h of bed rest (n = 42) in the control group following catheterization.

RESULTS

The mean age of children was 3.93 (±3.82) years in the experimental group and 5.63 (±3.97) years in the control group. There was no difference in site bleeding incidence (P = 0.214), vascular complication score (P = 0.082), pain level (P = 0.445), or additional sedation use (P = 1.000) between the two groups.

CONCLUSIONS

There were no significant hemostatic complications after 2 h of bed rest following pediatric catheterization; therefore, 2 h of bed rest was as safe as 4 h of bed rest. (Trial registration: KCT0007737).

摘要

背景

经股血管入路进行的儿科心导管术需要固定和卧床休息 4-6 小时,以预防血管并发症。成人研究表明,同一入路的固定时间可在导管术后安全减少至约 2 小时。然而,儿童导管术后卧床休息时间是否可以安全缩短尚不清楚。

目的

评估卧床休息时间对先天性心脏病儿童经股心导管术后出血、血管并发症、疼痛程度和额外镇静剂使用的影响。

方法

这是一项开放标签、随机、对照、仅后测试设计的研究,共纳入 86 例行心导管术的儿童。儿童被分配接受 2 小时(n=42)或 4 小时(n=42)的卧床休息。

结果

实验组儿童的平均年龄为 3.93(±3.82)岁,对照组为 5.63(±3.97)岁。两组在出血部位发生率(P=0.214)、血管并发症评分(P=0.082)、疼痛程度(P=0.445)或额外镇静剂使用(P=1.000)方面无差异。

结论

儿科导管术后 2 小时卧床休息后无明显止血并发症,因此 2 小时卧床休息与 4 小时卧床休息一样安全。(试验注册号:KCT0007737)。

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