Mayer D M, Hendrickx L
St Patrick Hospital, Missoula, Mont, USA.
Am J Crit Care. 1997 Sep;6(5):341-7.
Patients often have discomfort, especially back pain, after percutaneous transluminal coronary angioplasty because they must stay relatively flat while the sheath remains in the femoral vessel after the procedure. Flexible sheaths are now available, allowing the head of the bed to be raised to 60 degrees during this period of bed rest.
We assessed comfort and the frequency of bleeding in patients who had undergone percutaneous transluminal coronary angioplasty and compared the findings between patients with a flexible sheath and patients with a standard sheath.
Patients were randomly assigned either a flexible sheath or a standard sheath during percutaneous transluminal coronary angioplasty. Patients' comfort was assessed by administering a comfort questionnaire at two intervals after the procedure, and the frequency of bleeding was determined by reviewing the patients' charts.
One hundred seven patients completed the questionnaire. The patients with a flexible sheath showed a significantly higher level of comfort than the patients with a standard sheath 5 hours after the procedure. Patients with a flexible sheath also received less pain medication than did patients with a standard sheath. The frequency of bleeding was comparable in both groups.
Results of this study support the use of a flexible sheath to increase patients' comfort after percutaneous transluminal coronary angioplasty without increasing the frequency of bleeding.
经皮腔内冠状动脉成形术后患者常感不适，尤其是背痛，因为术后鞘管留置在股血管内时患者必须保持相对平卧位。现在有了可弯曲鞘管，在此卧床休息期间可将床头抬高至60度。
我们评估了接受经皮腔内冠状动脉成形术患者的舒适度和出血频率，并比较了使用可弯曲鞘管的患者和使用标准鞘管的患者的结果。
在经皮腔内冠状动脉成形术期间，患者被随机分配使用可弯曲鞘管或标准鞘管。术后通过在两个时间点进行舒适度问卷调查来评估患者的舒适度，并通过查阅患者病历确定出血频率。
107例患者完成了问卷调查。术后5小时，使用可弯曲鞘管的患者舒适度明显高于使用标准鞘管的患者。使用可弯曲鞘管的患者使用的止痛药物也比使用标准鞘管的患者少。两组的出血频率相当。
本研究结果支持使用可弯曲鞘管来提高经皮腔内冠状动脉成形术后患者的舒适度，且不增加出血频率。
