Effect Of Decompression Time On Postoperative Complications And Comfort Of TRA-PCI Patients

ObjectiveTo explore the influence of different decompression time on complications and comfort among patients after transradial access percutaneous coronary intervention(TRA-PCI).This study would provide the reference basis for reducing the postoperative complications and improving patient comfort,and provide supporting evidence for TRA-PCI postoperative nursing clinical practice guidelines.MethodConvenience sampling method was adopted.,420 cases of TRA-PCI postoperative were divided into A(138 cases),B(143 cases)and C(139 cases)three groups.All the patients were using rotary pressure hemostat to prevent bleeding.405 patients were eventually included,group A(133 cases),B(142 cases)and C(130 cases),respectively began to release pressure after 1 h,1.5 h,2 h.All the groups were completely relieved pressure after 10 h.General information questionnaire and Numerical Rating Scale(NRS),Kolcaba General Comfort Questionnaire(GCQ)were used to evaluate general conditions and the conditions of postoperative complications and comfort of TRA-PCI patients with different decompression time,such as haemorrhage,hematoma,swelling,radial artery occlusion pain scores and comfort.The effects of different decompression times on postoperative complications and comfort of TRA-PCI patients were analyzed.Data were analized by SPSS20.0 statistical package.Measurement data were analyzed by analysis of variance and categorical data were analyzed by chi-square test,with P<0.05 indicating the difference was statistically significant.Bonferroni correction chi-square was used for double groups compare,with P<0.05/3,as P<0.016 indicating the difference was statistically significant.Result1.All three groups of decompression methods were effective in hemostasis,but there was no significant difference in bleeding after TRA-PCI,and there was no statistically significant difference of the three groups(c~2=9.052,P=0.060).2.The three groups of TRA-PCI postoperative patients had different degrees of surgery side pain at different times.The majority were in mild pain.The degree of pain was reduced as pressure increased with the extension of time from the first time.Pain degrees contrast difference in three groups were statistically significant(c~2=17.427,P=0.002).Double group analysis results showed that group A of patients were significantly lower than group B and group C in pain degrees(P<0.001,P=0.012,respectively),and there was no difference between group B and group C(P=0.427).3.TRA-PCI postoperative patients had different degrees of lateral limb swelling in three groups at different times.The majority had level-I swelling.The differences were statistically significant in three groups(c~2=14.225,P=0.027).It was found that the swelling degree of group A and group C was different with statistical significance(P=0.004),while there was no significant difference between group A and group B(P=0.249);group B and group C(P=0.294).4.In all three groups,the Allen test was positive in 24 hours after surgery,and the early radial artery occlusion was not found.5.There were statistically significant differences between comfortable condition scores of three groups patients after operation 4 hours(F=12.146,P<0.001).Comparison results of each other showed that group A was more comfortable than group B(P=0.003)and group C(P<0.001),and group B scored higher than group C(P<0.001),and both differences were statistically significant.There were statistically significant differences in physiological dimension scores between the three groups(F=10.035,P<0.001).The comparison results of each other showed that group A scored higher than group B(P=0.006)and group C(P<0.001),and group B scored higher than group C(P=0.009),and all the differences were statistically significant.There were statistically significant differences in psychological dimension scores between the three groups(F=3.957,P=0.020).Comparison results of each other showed that group A of psychological dimension scores higher than group C(P=0.006),the difference was statistically significant.There was no statistically significant difference between group A and group B(P=0.312),and between group B and group C(P=0.070).Conclusion1.After the operation of TRA-PCI,it was safe to reduce pressure from the first hour,and the effect of preventing bleeding was more reliable.It did not increase the risk of complications such as bleeding and hematoma.2.After TRA-PCI,patients were experienced different degrees of intraoperative limb pain and swelling at different time,and the pain and swelling of the surgical limb were increased with the prolonged compression time.Pressure relieving from first hour after TRA-PCI can reduce the pain and swelling of the patients.3.After TRA-PCI,pressure relieving from first hour could improve the patient’s comfort level.