ABSTRACT
Objective To compare the incidences of skin ecchymosis,skin induration and pain degree occurring after subcutaneous injection of low molecular weight heparin between two injection methods in order to determine the optimal subcutaneous injection method and provide the basis for standardizing the nursing process.Methods A total of 123 patients,who received subcutaneous injection of low molecular weight heparin during the period from March 2016 to September 2016 at authors' department,were enrolled in this study.Self-contrast method was used to compare the results.Each patient received low molecular weight heparin with two different subcutaneous injection methods.On the left abdomen,used as the experimental side,slow injection of heparin,lasting for 10 s,was conducted,then,after the needle stayed there for 10s the needle was pulled out,and no compression was applied on the injection site.On the right abdomen,used as the control side,slow injection of heparin,lasting for 10 s,was carried out,and the needle was pulled out immediately after the injection was finished,then compression was applied on the injection site for 3 min.Two hours and 12 hours after injection,visual analogue scale (VAS) was used to assess the degree of pain at injection site,and the incidences of skin ecchymosis and subcutaneous induration on the experimental side and the control side were documented.Results Two-hour and 12-hour VAS pain scores of the experimental group were (0.88±0.66) and (0.34±0.47) respectively,which were significantly lower than (2.02±0.65) and (1.19±0.63) of the control group (P＜0.05).The incidence of skin ecchymosis in the experimental group was 10.5％,which was strikingly lower than 23.5％ in the control group (t=2.736,P＜ 0.05).The incidence of subcutaneous induration in the experimental group was 0.04％,which was remarkably lower than 15.4％ in the control group (t=2.946,P＜0.05).Conclusion Slow injection of low molecular weight heparin,lasting for 10 s with needle staying for 10 s,and no use of compression after the needle is pulled out can decrease the incidence of skin ecchymosis and subcutaneous induration,and this injection method can reduce the pain degree as well.
ABSTRACT
Objective To investigate the optimal pressure range produced by two types of air pressure cuff in order to block superficial vein to assist thrombolytic therapy for deep venous thrombosis (DVT) of lower extremity,which can effectively dissolve the thrombus as well as improve the patient's comfort,and to provide useful basis for the implementation of individualized and standard nursing process.Methods A total of 80 patients with lower limb DVT were randomly and equally divided into the modified air pressure cuff group (study group,n=40) and the traditional standard sphygmomanometer cuff group (control group,n=40).Thrombolytic therapy by using continuous intravenous infusion of urokinase via the dorsalis pedis vein with infusion pump was performed in all patients of both groups.The daily dose of urokinase was the same.The pressure value to obstruct lower limb superficial venous blood flow,that was the airbag pressure value when the deep veins of lower limb became visualized on venography,was determined.Leg swelling fade-away rate,mean thrombus clearance rate and patient's comfort degree,etc.were calculated,and the results were compared between the two groups.Results In the study group,the pressure value to block superficial venous blood flow of lower limb was 65-75 mmHg with a mean of (70±5) mmHg;which in the control group was 60-85 mmHg with a mean of (70±10) mmHg.The Leg swelling fade-away rate,the mean thrombus clearance rate determined at different time points,and the patient's comfort degree of the study group were remarkably better than those of the control group (P＜0.05).Conclusion Compared to the use of traditional standard sphygmomanometer cuff,the use of modified air pressure cuff to block the lower limb superficial venous blood flow can obtain better thrombolytic effect,meanwhile,the patients can get high comfort degree in the therapeutic process.