降低經皮穿腔冠狀動脈血管成形術後瘀青發生率

The Incidence of Decreased Echymosis after Removal of Sheath in Patient Receiving Percutaneous Transluminal Coronary Angioplasty

10.6142/VGHN.22.2.117

包玉綢(Yuh-Chour Bau)；高佳霙(Jia-Ying Gau)；余幸澄(Hsing-Cheng Yu)；何鴻鋆(Hung-Chin Ho)；謝育整(Yu-Cheng Hsieh)

經皮穿腔冠狀動脈血管成形術PTCA ； 股動脈鞘管 ； 瘀青發生率 ； PTCA Percutaneous Transluminal Coronary Angioplasty ； femoral sheath ； echymosis incidence

榮總護理

22卷2期（2005 / 06 / 01）

117 - 124

繁體中文

本專案旨在降低經皮穿腔冠狀動脈血管成形術(Percutaneous Transluminal Coronary Angioplasty, PTCA)病患拔除鞘管後之瘀青發生率，民國91年本單位接受股動脈PTCA病患（379人）拔除鞘管後之瘀青發生率爲27.7%。經由現況分析並篩選出可加以改善的原因有：止血期間病患缺乏活動自主性、止血過程病患腰酸背痛不適、止血工具無法有效固定。經由品管圈活動擬定改善對策：制定床上肢體活動衛教單張、改良止血工具、修訂心臟介入性檢查／治療後護理監測表、制定止血技術護理標準及查核表，於92年7月開始推行，並作追蹤評值。實施四個月後瘀青發生率由27.7%降至8.3%，使病患可以獲得一個安全、有效、舒適的止血過程。

This project aimed to decrease echymosis incidence after removal of the femoral sheath in patients who received percutaneous transluminal coronary angioplasty. The echymosis incidence after removal of femoral sheath was 28.4% among an estimated 379 patients who received percutaneous transluminal coronary angioplasty via femoral access in our coronary care unit in 2002. Correctable factors that affected echymosis rate was as follows: 1. Patients lacked daily activity during hemostasis. 2. Patients felt flank soreness during hemostasis. 3. The hemostasis tools did not work effectively. This refinement program designed by our quality control group was as follows: to design health education material, to improve hemostasis tools, to revise post coronary artery angiography / intervention monitor table and to design nursing hemostasis technique criteria and exam. The whole study began in July, 2003 with the following results: The echymosis incidence decreased from 28.4% to 8.3%, 4 months later. Besides patients required a safe, effective and smooth hemostasis course.