冠状动脉造影术后术肢康复护理的临床实践与研究

Clinical Practice and Study of Postoperative Limb Rehabilitation Nursing after Coronary Angiography

摘要: 目的：基于循证医学证据构建系统性康复护理策略，探讨其对提升介入术后术肢护理质量，推动患者快速康复的护理效果。方法：本研究选取2024年1月~2024年12月入住延安市安塞区人民医院心内科首次行冠状动脉造影术的患者作为研究对象，对照组实施常规护理，观察组实施术肢系统性康复护理策略，比较两组患者穿刺部位出血、血肿、动静脉瘘、手指功能障碍或桡动脉闭塞等术肢相关并发症发生率(术后3天内)、CAG术后2小时与术后8小时穿刺部位疼痛VAS评分、平均住院时间(天)。两组冠脉造影患者穿刺部位并发症比较采用χ²检验；计量资料两组患者组间比较采用t检验或非参数检验，以P < 0.05为差异具有统计学意义。结果：本研究是一项病例对照研究，对照组回顾性地收集了50例2024年1月~2024年6月在我院心血管内科住院行冠脉造影术并且采用常规护理的患者相关资料；2024年6月~2024年12月在我院心血管内科住院行冠脉造影的患者，作为观察组，采用术肢系统性康复护理策略，纳入50例患者。不同护理方案CAG术后3天内观察术肢总并发症：观察组8.0% vs对照组28.0%，(P < 0.05)；观察组患者平均住院天数为4 (3, 4)天，低于对照组平均住院天数4 (4, 5)天，(P < 0.05)；不同护理方案CAG术后2小时术肢疼痛在疼痛VAS评分上无显著差异(P > 0.05)，实施术肢系统性康复护理策略的观察组患者其在CAG术后8小时术肢疼痛显著低于对照组患者，差异具有统计学意义(P < 0.05)。结论：冠状动脉造影术后术肢康复护理的标准化(逐步减压技术、握拳锻炼指导)和人性化(如心理支持、个体化宣教)可以降低CAG患者术后术肢相关并发症发生率，缩短患者住院时间，提升了患者舒适度及术后康复质量。

Abstract: Objective: To establish a systematic rehabilitation nursing strategy based on evidence-based medical evidence, and explore its nursing effect on improving the quality of surgical limb nursing after interventional surgery and promoting rapid recovery of patients. Methods: In this study, patients admitted to the Department of Cardiology, Ansai District People’s Hospital of Yan’an City from January 2024 to December 2024 who underwent coronary angiography for the first time were selected as the study objects. The control group received routine nursing, and the observation group received systematic rehabilitation nursing strategies for operative limbs. The incidence of postoperative complications such as puncture site bleeding, hematoma, arteriovenous fistula, finger dysfunction or radial artery occlusion (within 3 days after surgery), VAS score of puncture site pain at 2 hours and 8 hours after CAG surgery, and average length of hospital stay (days) were compared between the two groups. The complication of puncture site was compared between the two groups by χ² test. Measurement data between the two groups were compared by t test or non-parametric test, and P < 0.05 was considered to be statistically significant. Results: This study was a case-control study. The control group retrospectively collected the relevant data of 50 patients who were admitted to the Department of Cardiovascular Medicine of our hospital from January 2024 to June 2024 and received routine care. Patients admitted to the cardiovascular department of our hospital for coronary angiography from June 2024 to December 2024, as the observation group, 50 patients were included by the surgical limb systematic rehabilitation nursing strategy. The total complications of the operative limb within 3 days after CAG under different nursing schemes were observed: 8.0% in the observation group vs. 28.0% in the control group (P < 0.05); The average days of hospitalization in observation group was 4 (3, 4) days, which was lower than that in control group 4 (4, 5) days, (P < 0.05). There was no significant difference in the pain VAS score of postoperative limb pain 2 hours after CAG with different nursing schemes (P > 0.05). The postoperative limb pain 8 hours after CAG in the observation group with systematic rehabilitation nursing strategy was significantly lower than that in the control group, the difference was statistically significant (P < 0.05). Conclusion: The standardization of postoperative limb rehabilitation nursing (step-decompression techniques, hand-clench exercise guidance) and humanization (such as psychological support and individualized education) can reduce the incidence of postoperative limb related complications in CAG patients, shorten the length of hospital stay, and improve the comfort level of patients and the quality of postoperative rehabilitation.