Coyne C, Baier W, Perra B, Sherer B K
University of Washington Medical Center, Seattle 98195.
Am J Crit Care. 1994 Jul;3(4):282-8.
Protocol at most centers requires keeping the head of the bed flat for at least 5.5 hours after coronary angiography.
To determine the effect of head of bed elevation after diagnostic coronary angiography on patient comfort and on the incidence and timing of postprocedural complications.
A convenience sample of 120 adult patients on the short-stay special procedures nursing unit of a university teaching hospital was used. Patients who had undergone elective diagnostic coronary angiography via the femoral artery were randomly assigned to a control or experimental group. The control group had the head of bed maintained at 15 degrees or less for 5.5 hours after the procedure. The experimental group had the head of bed gradually elevated from 15 degrees to 60 degrees over the 5.5 hours. Both groups dangled and ambulated after 5.5 hours. All other aspects of the procedure were identical. Outcome was measured by incidence and timing of dizziness, hypotension, bleeding, hematoma, and diminished foot pulses. Level of pain was assessed on a scale of 0 to 10.
No statistically significant differences were noted between groups in the incidence of complications. The incidence of back pain at a level of more than 3 on a scale of 0 to 10 was less for the experimental group than for the control group.
Elevation of the head of the bed after coronary angiography decreases discomfort with no increase in complications. Replication of this study is needed for verification.
大多数中心的诊疗规范要求冠状动脉造影术后将床头保持水平至少5.5小时。
确定诊断性冠状动脉造影术后床头抬高对患者舒适度以及术后并发症的发生率和发生时间的影响。
选取一所大学教学医院短期特殊手术护理单元的120例成年患者作为便利样本。经股动脉接受择期诊断性冠状动脉造影的患者被随机分为对照组和试验组。对照组术后将床头保持在15度或更低水平5.5小时。试验组在5.5小时内将床头从15度逐渐抬高至60度。两组在5.5小时后均进行垂腿坐立和下床活动。手术的所有其他方面均相同。通过头晕、低血压、出血、血肿和足背动脉搏动减弱的发生率和发生时间来衡量结果。疼痛程度采用0至10分进行评估。
两组并发症发生率无统计学显著差异。试验组0至10分中背痛程度超过3分的发生率低于对照组。
冠状动脉造影术后抬高床头可减轻不适且不增加并发症。需要重复本研究以进行验证。
