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@#Objective To explore the influence of applying the fast-track surgery (FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery. Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group (n=95) and a FTS group (n=95) by random umber table. There were 60 males and 35 females aged 35-88 (65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86 (61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital (P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients’ self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.
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<p><b>OBJECTIVE</b>To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS).</p><p><b>METHODS</b>A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan (AH), Shenmen (TF), Pizhixia (AT), Neifenmi (CO), Xin (CO), Shen (CO), Shenshangxian (TG), 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections.</p><p><b>RESULTS</b>The incidence of angiospasm was 4.9% (11/224) in the observation group, which was lower than 13.3% (34/256) in the control group (<0.01). The incidence of vagal reflex of the observation group was 7.1% (16/224), which was lower than 19.5% (50/256) of the control group (<0.01). The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6% (8/224), 7.1% (16/224), 6.3% (14/224) respectively in the observation group, which were lower than 14.8% (38/256), 15.6% (40/256), 15.2% (39/256) in the control group (all<0.01). .</p><p><b>CONCLUSION</b>Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.</p>
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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To observe the clinical effects and complications of coronary intervention through radial artery and femoral artery.Methods A hundred and sixty patients received coronary intervention treatment or coronary angiogram in the Second Affiliated Hospital of Bengbu Medical College from March 2010 to March 2015 were enrolled in this study.The patients were divided into radial artery puncture group (n =80),who received radial artery puncture and femoral artery puncture group (n =80) who received femoral artery puncture.The general date such as puncture time,intervention success rate,time in bed,postpuncture compression time and complications such as postoperative bleeding,arterial occlusion and postoperative untoward reactions were recorded and compared.Results The intervention success rate of radial artery puncture group was 90.0％ lower than that of femoral artery puncture group (97.5％),with statistically significant differences (P＜0.05).The puncture time,postpuncture compression time,time in bed and hospital stays of radial artery puncture group were significantly shorter than those of femoral artery puncture group (P ＜0.01).As for complications,the incidences of postpuncture bleeding and vagus nerve reflex in radial artery puncture group were significantly lower than that in femoral artery puncture group (P＜0.05).As for postoperative untoward reactions,the incidences of irritable and insomnia,uroschesis,pain caused by puncture,local skin injure,back pain in radial artery puncture group were significantly lower than those in femoral artery puncture group (P＜0.01).Conclusion With the advantages of mini-invasion,such as shorter time in bed and hospital stays,lower complications and untoward reactions rates,coronary intervention through radial artery is worth of clinical application.
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Objective To study the effect of whole-process nursing intervention on comfort of patients undergoing radial artery puncture. Methods 100 patients with radial artery puncture from July, 2007 to June, 2008 were divided into the control group and the experimental group with 50 cases in each group accord-ing to time sequence. Routine whole nursing mode was used in the control group, the whole-process nursing intervention mode based upon routine nursing mode under the instruction of evidence-based method was used in the experimental group. Pain, psychological tensity, body numbness, success rate of radial artery puncture, patients' satisfaction degree were compared between the two groups. Results Every indexes of the experi-mental group were better than those of the control group. Conclusions The whole-process nursing interven-tion mode can promote the comfort degree of patients undergoing radial artery puncture.