CAJ | 학술논문

目的：探讨肢体抬高法在老年患者外周静脉输液拔针后血管止血中的应用与效果。方法选取180例行外周静脉穿刺的老年患者为研究对象，随机分为对照组、观察组各90例。对照组采用常规肢体按压法，患者拔针后在按压的30，60，90，120，150，180，210，240，270，300 s分别观察穿刺点有无渗血，记录止血时间，观察24 h穿刺点处淤青发生率。观察组采用肢体抬高法在患者拔针后直接观察止血的有效时间，记录止血时间、淤青发生率、拔针前后患者的血压、脉搏测量值。结果观察组有效止血时间为15～100 s，平均（53．50±22．84）s；对照组为60～240 s，平均（164．99±50．01）s，两组患者拔针后的有效止血时间比较，差异有统计学意义（t＝8．884，P＜0．01）。观察组患者拔针前及拔针后脉搏、收缩压比较，差异无统计学意义（t值分别为1．278，0．507；P＞0．05），舒张压比较差异有统计学意义（t＝2．984，P＜0．05）。观察组2例有淤青，均为轻度，对照组18例有淤青，其中轻度17例，中度1例，两组比较差异有统计学意义（ Z＝108．89，P＜0．05）。结论应用肢体抬高法对老年患者输液完毕进行血管止血的效果优于传统按压法，可明显缩短止血时间，减少皮下淤青的发生，并确保老年患者的主要生命体征安全。
목적：탐토지체태고법재노년환자외주정맥수액발침후혈관지혈중적응용여효과。방법선취180례행외주정맥천자적노년환자위연구대상，수궤분위대조조、관찰조각90례。대조조채용상규지체안압법，환자발침후재안압적30，60，90，120，150，180，210，240，270，300 s분별관찰천자점유무삼혈，기록지혈시간，관찰24 h천자점처어청발생솔。관찰조채용지체태고법재환자발침후직접관찰지혈적유효시간，기록지혈시간、어청발생솔、발침전후환자적혈압、맥박측량치。결과관찰조유효지혈시간위15～100 s，평균（53．50±22．84）s；대조조위60～240 s，평균（164．99±50．01）s，량조환자발침후적유효지혈시간비교，차이유통계학의의（t＝8．884，P＜0．01）。관찰조환자발침전급발침후맥박、수축압비교，차이무통계학의의（t치분별위1．278，0．507；P＞0．05），서장압비교차이유통계학의의（t＝2．984，P＜0．05）。관찰조2례유어청，균위경도，대조조18례유어청，기중경도17례，중도1례，량조비교차이유통계학의의（ Z＝108．89，P＜0．05）。결론응용지체태고법대노년환자수액완필진행혈관지혈적효과우우전통안압법，가명현축단지혈시간，감소피하어청적발생，병학보노년환자적주요생명체정안전。
Objective To discuss the effect of limb elevation method on hemostasis after extraction of venous infusion needle in elderly patients .Methods Totals of 180 patients with peripheral venous infusion needle were randomly divided into the control group and the observation group , with 90 patients in each group . The control group, using the conventional body press method , were observed the hemostasis effect at 30, 60, 90, 120, 150, 180, 210, 240, 270, 300 s after pressing and recorded the incidence of bleeding time .For the observation group , using the limb elevation method after withdrawal the needles , recorded the hemostatic time , the incidence of bruising and measured the blood pressure and pulse rate before and after removal the needles . Results The effective hemostatic time was 15-100 s for the observation group , with an average of (53.50 ± 22.84)s, and 60-240 s for the control group, with an average of (164.99 ±50.01)s, and the difference was significant (t=8.884, P<0.01).The differences of systolic blood pressure and pulse rate of the observation group before and after removal the needle had no significant difference ( t=1.278, 0.507, respectively;P>0.05), while the difference of diastolic blood pressure had significant difference (t=2.984,P<0.05).Two patients in the observation group had mild bruise , and eighteen patients in the control group had mild to moderate bruise, which was significantly different (Z=108.89,P<0.05).Conclusions The lime elevation method had a better hemostasis effect for elderly patients , which can significantly shorten bleeding time , reduce the occurrence of subcutaneous bruising and ensure the safety of elderly patients .