Effects Of Planned Decompression Combined With Limb Exercise On Limb Swelling,Pain And Numbness After Trans-radial Coronary Intervention

ObjectiveThis study was aimed at an in-depth research into the effects of planned decompression combined with limb exercise on limb swelling,pain and numbness after trans-radial coronary intervention,and thus develops a set of easy and feasible limb exercise program to improve the patients' comfort and safety,accelerate their recovery and provide evidences for postoperative nursing on TRI patients.MethodsA randomized single blind method was used in this study.A total of 228 cases of patients from the Cardiology ward of The Third Affiliated Hospital of Soochow University(The First People's Hospital of Changzhou)took part in the study.According to the random number table method,the patients were divided into intervention groups 1,2 and 3 as well as control group at a ratio of 1:1.All of the 4 groups were given normal perioperative nursing during the operational period.After the operations,planned decompression program was carried out within Intervention group 1 and limb exercise program was carried out within Intervention group 2,while planned decompression combined with limb exercise were carried out within Intervention group 3.For the Control group,normal decompression treatment was given to the patients.Limb swelling,bleeding,pain,vital signs(blood pressure/pulse rate),pressure injuries as well as quality of sleep were evaluated 1 day prior to the operation,and 2 hours,6 hours,24 hours after the operation.Results1.There were no significant statistical differences(P>0.05)among the four groups in basic clinical data such as gender,age,BMI,occupation,hypertension history,history of cigarette smoking,alcohol consumption,quality of sleep,limb volume,the operative type,basic blood pressure and pulse rate.2.Degree of limb swelling:There was statistical difference(F=3.289/5.599/2.720,P<0.05)on the comparison result of the four groups on their limb volume after the operation at any intervention times.(i)2 hours after the operation,there was no significant statistical difference(P>0.05)on the limb volume between Intervention group 3 and Intervention group 1,while there was statistical difference(P<0.05).(?there was statistical difference(P<0.05)on the limb volume between Intervention group 3 and the rest of groups 6 hours and 24 hours after the operation.3.Bleeding:there was no significant statistical difference(?2=0.630,P=0.890)on the bleeding of all the four groups.4.Pain:There was statistical difference(Z=15.770/42.121,P=0.001/0.000)on the comparison result of the four groups on pain at 2 hour and 6 hour after the operation,while there was no significant statistical difference(Z=4.054,P=0.256)at 24 hour after the operation.2 hours after the operation,there was no significant statistical difference(P>0.05)on the pain between Intervention group 3 and Intervention group 1,while there was statistical difference(P<0.05)on the comparison respectively between Intervention group 3/Intervention group 1 and Intervention group 2/control group.5.Blood pressure and pulse rate 2 hours after the operation:comparison results on pulse rate of the four groups showed no statistical difference(F=1.715,P=0.165).Comparison results on blood pressure of the four groups showed statistical difference(F=4.916,P=0.003)(F=2.943,P=0.034).There were statistical differences(P<0.05)on the comparison results of the 3 Intervention groups and control group.6.Numbness:There was statistical difference(Z=14.801/37.724/7.799,P<0.01)on the comparison result of the four groups on their limb numbness after the operation at any intervention times.(?)2 hours after the operation,there was no significant statistical difference(P>0.05)on the numbness between Intervention group 3 and Intervention group 1,and in the meantime,there was statistical difference(P<0.05)between Intervention group 2 and control group.(?)There were statistical differences(P<0.05)on the comparison results of Intervention group 3 and the rest of three groups 6 hours and 24 hours after the operation.7.Pressure Injuries:the comparison results of pressure injuries of the four groups 24 hours after the operation showed that there were statistical differences(?2=9.177,P=0.027)?There was statistical difference between Intervention group 1 and control group(Z=2.11,P=0.035),Intervention group 3 and control group(Z=2.360,P=0.018).8.Quality of sleep:there was statistical difference(Z=24.030,P<0.01)on the comparison result of the four groups on their sleep quality.There was statistical difference between Intervention group 3 and Intervention group 1,Intervention group 3 and control group(P<0.01).Conclusion1.Planned decompression combined with limb exercise can help relief limb swelling after TRI operations,and has a better effect than simple planned decompression or limb exercise;2.Planned decompression combined with limb exercise increases no risks in bleeding after TRI operations;3.Planned decompression combined with limb exercise helps relief the pain after TRI operations and reduces the incidence of pressure injuries;4.Planned decompression combined with limb exercise helps relief the numbness and has lower impact on the sleep quality;5.The three types of intervention can all ease blood pressure fluctuation 2 hours after the TRI operations.