目的 探讨术后早期活动对经股静脉行心导管射频消融患者舒适度及并发症的影响。方法 2016年4月至2017年4月,经股静脉径路行心导管射频消融术的心律失常患者120例随机分为对照组、试验A组和试验B组,各40例。对照组术后常规患肢制动4 h,卧床8 h后下地行走;试验A组术后患肢制动4 h后下地行走;试验B组术后床上体位干预,4 h后下地行走。采用舒适状况量表、疼痛数字分级量表和状态焦虑量表进行评估,记录各组并发症发生情况。结果 三组穿刺部位出血及血肿的发生率无显著性差异(P>0.05);试验B组较对照组舒适度提高(P<0.05),试验组较对照组腰背疼痛强度显著降低(F>10.376, P<0.001),焦虑程度减轻(t=3.278, P<0.05),肢体麻木、入睡困难、食欲下降、排尿困难等不良反应的发生率降低(χ2>6.409, P<0.05)。试验B组整体状况最好。结论 经股静脉心导管射频消融术后,患者早期活动不会增加穿刺部位血管并发症发生率,能显著提高术后患者舒适度。
Objective To investigate the effect of early ambulation on the comfort and complications in patients undergoing radiofrequency catheter ablation via femoral vein approach. Methods From April, 2016 to April, 2017, 120 patients were randomly assigned into control group (n=40), group A (n=40) and group B (n=40). The control group received the routine care of remaining bed rest for eight hours with the affected leg immobilized at least four hours. Group A ambulated after four hours of the affected leg immobilization, and group B changed their position after ablation and ambulated after four hours of bed rest. They were assessed with the General Comfort Questionnaire, Numerical Rating Scale of back pain and State Anxiety Inventory. Their vascular complications were recorded. Results The incidence of bleeding and hematoma was not significantly different among the groups (P>0.05). Group B was more comfortable than the control group (P<0.05). Compared with the control group, groups A and B were less in back pain intensity (F>10.376, P<0.001), and had less anxiety (t=3.278, P<0.05), less incidence of limb numbness, difficulty falling asleep, and loss of appetite and dysuria (χ2>6.409, P<0.05). Group B was the best among them.Conclusion There is little risk of early physical activity and ambulation in the vascular complications after radiofrequency catheter ablation via femoral vein approach, which may reduce their discomfort.
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