CAJ | 학술논문

目的：观察经皮冠状动脉介入治疗术后应用改良注射法注射低分子肝素的临床效果。方法将220例行经皮冠状动脉介入治疗且术后应用低分子肝素治疗的患者，随机分为常规注射组及改良注射组两组，各110例。分别给予低分子肝素常规注射法治疗和改良注射法治疗，对比治疗效果。结果改良注射组注射皮下瘀斑及皮下硬结发生率分别为86.36%和31.81%，明显低于常规注射组的95.45%和59.09%（χ2=5.5000，P=0.0190；χ2=16.5000，P=0.0000）；改良注射组注射疼痛程度为（3.16±1.11）分，常规注射组为（4.27±1.35）分，改良注射组明显优于常规注射组（ t=－6.6610，P=0.0000）；同时改良注射组发生皮下瘀斑及皮下硬结患者皮下瘀斑及皮下硬结面积为（1.35±0.67）cm2及（1.21±0.63）cm2，均明显低于常规组（ t=9.4125，P=0.0000；t=10.8503，P=0.0000）。此外两组治疗前后凝血酶原时间（PT）、部分凝血活酶活性时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）比较均未见统计学差异（ P>0.05）。结论改良注射法可明显改善经皮冠状动脉介入治疗术后的注射效果，且不影响患者的凝血四项。
목적：관찰경피관상동맥개입치료술후응용개량주사법주사저분자간소적림상효과。방법장220례행경피관상동맥개입치료차술후응용저분자간소치료적환자，수궤분위상규주사조급개량주사조량조，각110례。분별급여저분자간소상규주사법치료화개량주사법치료，대비치료효과。결과개량주사조주사피하어반급피하경결발생솔분별위86.36%화31.81%，명현저우상규주사조적95.45%화59.09%（χ2=5.5000，P=0.0190；χ2=16.5000，P=0.0000）；개량주사조주사동통정도위（3.16±1.11）분，상규주사조위（4.27±1.35）분，개량주사조명현우우상규주사조（ t=－6.6610，P=0.0000）；동시개량주사조발생피하어반급피하경결환자피하어반급피하경결면적위（1.35±0.67）cm2급（1.21±0.63）cm2，균명현저우상규조（ t=9.4125，P=0.0000；t=10.8503，P=0.0000）。차외량조치료전후응혈매원시간（PT）、부분응혈활매활성시간（APTT）、응혈매시간（TT）、섬유단백원（FIB）비교균미견통계학차이（ P>0.05）。결론개량주사법가명현개선경피관상동맥개입치료술후적주사효과，차불영향환자적응혈사항。
Objective To explore the clinical effect of improved injection of low molecular weight heparin after coronary artery interven-tional operation. Methods 220 cases of coronary arterial interventional therapy and postoperative low molecular heparin treatment were randomly divided into the conventional injection group and the improved injection group with 110 cases in each group, and were given the treatment of low molecular weight heparin by the routine injection and the improved injection respectively. The injection effects were compared between the two groups. Results The occurrence rates of subcutaneous ecchymosis and subcutaneous induration in the im-proved injection group were 86. 36% and 31. 81% respectively, which were significantly lower than those in the conventional injection group were 95. 45% and 59. 09%(χ2=5. 5000, P=0. 0190; χ2=16. 5000, P=0. 0000 );the pain degree in the improved injection group was ( 3. 16 ± 1. 11 ) points, which in the conventional injection group was ( 4. 27 ± 1. 35 ) , indicating that the improved injection group was significantly superior to the conventional injection group with statistical difference ( t= -6. 661 0, P=0. 000 0 ); at the same time the subcutaneous ecchymosis and subcutaneous induration area in the patients with subcutaneous ecchymosis and subcutaneous induration of the improved injection group were ( 1. 35 ± 0. 67 ) cm2 and ( 1. 21 ± 0. 63 ) cm2 respectively, which were significantly lower than those in the convention injection group with statistical differences ( t=9. 4125, P=0. 000 0; t=10. 850 3, P=0. 000 0 ) . In addition PT, APTT, TT and FIB before and after treatment had no statistical differences between the two groups( P > 0. 05). Conclusion The improved injection method can obviously improve the injection effect of low molecular weight heparin after coronary artery intervention operation without affecting blood coagulation 4 indexes in the patients.