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관상동맥 조영술을 받은 환자에서 출혈방지와 안위증진을 위한 중재 효과
정연이,이정희,허은희,곽인옥,백규원,장은미,박미순,오영주,전보윤,허진연,권윤의,최화영,백목련 병원간호사회 2001 임상간호연구 Vol.7 No.2
Objective : Delayed bleeding and back pain are major concerns in who receive coronary angiography. We investigated the six different post-procedure during recovery from coronary angiography. The six post-procedures were as following: elevation of the head of the bed(flat versus 15-30 degree), application of sandbag on the puncture site(use versus no use) and prolongation of immobilization time(4 versus 8 hours). The primary goal of this study was to promote less post-procedural discomfort and therefore improve clinical outcome of coronary angiography. Design : Experimental, pretest-posttest, random assignment Sample : From July 2000 to January 2001, 102 patients underwent coronary angiography through femoral artery cardiology at Samsung Medical Center. Intervention : 1. The elevation of the head of the bed : control group(n=22) with 0 degree elevation versus the experimental group(n=20) with 15~30 degrees 2. The use of sandbag on the puncture site : control group(n=20) with sandbag versus the study group (n=20) without sandbag. 3. The duration of immobilization after angiography control group with 4 hours immobilization(n=20) versus the experimental group(n=20) with 8 hrs. Intervention 2 & 3 were cross tested. For 24hours after cardiac angiography, the nurse reported the presence of complication on the assessment tool (bleeding, hematoma formation, back pain and uninary retention) Results 1. Hemodynamic and angiographic variables were evenly distributed and the basic characteristics of study groups were similar. 2. The degree of elevation of the head of the bed, there's no significant differences in bleeding complications, low back pain and urinary discomfort in both groups. 3. For the effects of sandbag, there were no significant differences in bleeding complication, low back pain and urinary discomfort in both experimental and control group, and not related with the length of the time for immobilization 4. There was no significant difference between four and eight hour immobilization groups with no sandbag application in bleeding complication. There was significant decrease in incidence of patient's subjective discomfort and low back pain after four hour immobilization. The incidence of bleeding complications was not increased in any study groups. Therefore, we recommend shorter length of immobilization time(4 hours in our study) at patient's convenience in order to decrease patient's discomfort. The application of sandbag and the head elevation of the bed may be optional since it did not decrease immediate complications of angiography.
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