CAJ | 학술논문

目的：了解老年冠心病患者经皮冠状动脉介入治疗（PCI）术后周围血管并发症的发生状况，探讨老年冠心病患者PCI术后周围血管并发症发生的相关因素。方法采用横断面调查研究方法，以便利抽样抽取行PCI术的老年冠心病患者103例，并采用自行设计的PCI术老年冠心病患者人口学资料表和疾病相关资料表进行数据收集。结果老年冠心病患者PCI术后有21．4％发生了周围血管并发症，发生最多的是局部渗血13．6％，其次是血肿4．9％、穿刺点周围皮下淤斑2．9％、前臂肿胀2．9％；不同年龄、不同婚姻状况，术前是否合并高脂血症、不同穿刺部位、不同手术时机、不同手术持续时间、不同病变血管支数、术中不同肝素用量、术中及术后不同盐酸替罗非班氯化钠注射液用量、术中硫酸氢氯吡格雷片用量，PCI术后的老年冠心病患者周围血管并发症发生状况有所不同，差异有统计学意义（ P＜0．05）；Logistic回归分析发现，婚姻状况、穿刺部位、病变血管支数、术中肝素用量、术后硫酸氢氯吡格雷片是PCI术后发生周围血管并发症的危险因素。结论年龄越大、非在婚、合并高脂血症、急诊手术、手术持续时间长、经股动脉穿刺、病变血管支数多、前降支狭窄程度大、术中肝素用量大、术后使用盐酸替罗非班氯化钠注射液、硫酸氢氯吡格雷片的患者更易发生周围血管并发症，提示在今后的护理工作中，应该把此类患者作为护理的重点。
목적：료해노년관심병환자경피관상동맥개입치료（PCI）술후주위혈관병발증적발생상황，탐토노년관심병환자PCI술후주위혈관병발증발생적상관인소。방법채용횡단면조사연구방법，이편리추양추취행PCI술적노년관심병환자103례，병채용자행설계적PCI술노년관심병환자인구학자료표화질병상관자료표진행수거수집。결과노년관심병환자PCI술후유21．4％발생료주위혈관병발증，발생최다적시국부삼혈13．6％，기차시혈종4．9％、천자점주위피하어반2．9％、전비종창2．9％；불동년령、불동혼인상황，술전시부합병고지혈증、불동천자부위、불동수술시궤、불동수술지속시간、불동병변혈관지수、술중불동간소용량、술중급술후불동염산체라비반록화납주사액용량、술중류산경록필격뢰편용량，PCI술후적노년관심병환자주위혈관병발증발생상황유소불동，차이유통계학의의（ P＜0．05）；Logistic회귀분석발현，혼인상황、천자부위、병변혈관지수、술중간소용량、술후류산경록필격뢰편시PCI술후발생주위혈관병발증적위험인소。결론년령월대、비재혼、합병고지혈증、급진수술、수술지속시간장、경고동맥천자、병변혈관지수다、전강지협착정도대、술중간소용량대、술후사용염산체라비반록화납주사액、류산경록필격뢰편적환자경역발생주위혈관병발증，제시재금후적호리공작중，응해파차류환자작위호리적중점。
Objective To understand the situation of the incidence of peripheral vascular complications after percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease , and to explore its related factors.Methods One hundred and three elderly patients with coronary heart disease after PCI were chosen according to the convenient sampling through the cross-sectional study , and were surveyed by the self-designed demographic tables and disease-related tables, and the data were collected and analyzed .Results The incidence of peripheral vascular complications was 21.4% in the elderly patients with coronary heart disease after PCI, and the incidence of local oozing bleeding was the most (13.6%), followed by 4.9% of the hematoma, 2.9% of subcutaneous ecchymosis around puncture point , 2.9% of forearm swelling.The occurrence of peripheral vascular complications was different in the patients with different age , marital status, combined with hyperlipidemia , puncture site , surgical time , duration of surgery , number of diseased vessels , the use of heparin during operation , postoperative use of Tirofiban and Plavix , and the differences were statistically significant ( P <0.05 ) .Logistic regression analysis showed that the related factors of peripheral vascular complications after PCI included the marital status , puncture site , number of diseased vessels , intraoperative use of heparin , postoperative use of Tirofiban and Plavix .Conclusions The patients with older , non-marriage, emergency surgery , long time of surgery , puncture through the femoral artery , many diseased vessels, severe anterior descending artery stenosis , intraoperative use of large heparin , postoperative use of Tirofiban and Plavix are more susceptible to peripheral vascular complications , which suggests that we should put these patients as the focus of nursing in the future work .