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目的探讨皮下注射低分子肝素钙后局部按压时间与皮下出血及出血面积的关系。方法选取常州市金坛区中医医院2013年1月—2017年1月行冠状动脉支架植入术后皮下注射低分子肝素钙患者100例,每例注射10次,样本量为1000例次。按照患者皮下注射后按压时间分为5组,每组200例次,按压时间分别为2 min、3min、4 min、5 min、6 min。12 h后观察局部皮下出血情况、出血面积及有无硬结。结果 1000例皮下注射中出现了皮下出血283例(28.3%),其中出血面积≤2 cm×2 cm 179例(17.9%),>2 cm×2 cm 104例(10.4%)。随着按压时间的延长,注射后局部出血情况呈下降趋势,且按压4 min时下降最为显著。不同按压时间后出血率比较,差异有统计学意义(P<0.05);3 min出血率高于4 min(P<0.05)。不同按压时间患者出血面积比较,差异有统计学意义(P<0.05)。结论皮下注射低分子肝素钙后局部按压时间长短与出血发生率及出血面积相关,临床应用该药物时应适当增加按压时间,用药期间加强观察,做好健康宣教。
Objective To investigate the relationship between subcutaneous injection of low molecular weight heparin calcium after local compression time and subcutaneous hemorrhage and bleeding area. Methods 100 cases of low molecular weight heparin in subcutaneous injection of coronary artery stent implantation were selected from Jintan District Hospital of Traditional Chinese Medicine, Changzhou from January 2013 to January 2017. The injection volume was 1000 cases per injection. According to the time of subcutaneous injection, patients were divided into 5 groups with 200 cases in each group. The pressing time was 2 minutes, 3 minutes, 4 minutes, 5 minutes, 6 minutes respectively. After 12 h observe the local subcutaneous bleeding, bleeding area and whether the induration. Results A total of 283 (28.3%) cases of subcutaneous hemorrhage occurred in 1000 cases of subcutaneous injection, of which 179 (17.9%) were bleeding ≤ 2 cm × 2 cm and 104 (10.4%) were> 2 cm × 2 cm. With the prolonging of the pressing time, the local bleeding after the injection showed a downward trend, and the drop was the most significant when the pressure was kept for 4 minutes. The bleeding rate after different pressing time was significantly different (P <0.05). The bleeding rate was higher than 4 min after 3 min (P <0.05). The bleeding area of patients with different compression time, the difference was statistically significant (P <0.05). Conclusion The subcutaneous injection of low molecular weight heparin after local press time and bleeding rate and bleeding area related to the clinical application of the drug should be appropriate to increase the pressing time, strengthen observation during the medication, good health education.