中国药物警戒 ›› 2017, Vol. 14 ›› Issue (2): 116-118.

• 安全性评价与合理用药 • 上一篇    下一篇

给药操作对首次注射低分子肝素患者局部不良反应发生的影响分析

胡萍   

  1. 信阳职业技术学院附属医院,河南 信阳 464000
  • 收稿日期:2017-03-10 修回日期:2017-03-10 出版日期:2017-02-20 发布日期:2017-03-10
  • 作者简介:胡萍,女,本科,副主任药师,医院药学与药事管理等。

Relationship between the Incidence of Adverse Reactions and Injection Mode on Patients First Given Low Molecular Weight Heparin

HU Ping   

  1. Affiliated Hospital of Xinyang Vocational and Technical College, Henan Xinyang 464000, China
  • Received:2017-03-10 Revised:2017-03-10 Online:2017-02-20 Published:2017-03-10

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摘要： 目的 探讨给药操作对急性心梗患者首次注射低分子肝素不良反应发生率的影响。方法 选取2016年3月到4月在我院就诊的首次进行低分子肝素注射的急性心梗患者72例作为研究对象,随机分为6组：A、B、C组注射时长为10 s,按压时间分别为0、5、10 min;D、E、F组注射时长为30 s,按压时长分别为0、5、10 min。参照4点口述分级疼痛评分法将原有的4级疼痛改为3级（无疼痛;轻微疼痛;中等疼痛）评价注射局部疼痛程度;记录患者出血情况（轻度、中度、重度）。结果 同等注射时长下,按压5 min和按压10 min皮下出血率小于不按压（P<0.05）,按压5 min和按压10 min出血量比较,差异无统计学意义（P>0.05）,按压0 min、按压5 min和按压10 min疼痛程度比较,差异无统计学意义（P>0.05）;同等按压时间,注射30 s患者出血量小于10 s,其差异具有统计学意义（P<0.05）,注射30 s局部疼痛程度低于10 s,其差异具有统计学意义（P<0.05）。结论 为了减少急性心梗患者注射低分子肝素时的出血和注射局部疼痛,在注射时应将注射时间维持在30 s,并在注射后按压至少5 min。

关键词: 低分子肝素, 局部疼痛, 四点口述分级疼痛评分, 出血量

Abstract: Objective To investigate the effect of low molecular weight heparin injection mode to the incidence of adverse drug reactions in patients with acute myocardial infarction.Methods From March to April in 2016, 72 patients were randomly assigned to receive low molecular weight heparin injection in our hospital and divided into 6 groups: group A, B, C: injection for 10 s and pressing for 0, 5, 10 min. Group D, E, F: injection for 30 s and pressing for 0, 5, 10 min. The original grade 4 pain was changed to grade 3 (no pain, mild pain and moderate pain) according to the 4 point verbal rating scale. The degree of local pain of injection was evaluated and the patient’s bleeding (mild, moderate, severe) was recorded.Results Under the same injection length, subcutaneous bleeding rate on group pressing 5 min and pressing 10 min was less than non-compression (P < 0.05), group between pressing 5 min and pressing 10 min blood had no significant difference (P > 0.05). There was no statistically significant difference on pain degree among pressing 0, 5, 10 min (P > 0.05). Under the same pressing time, bleeding amount and local pain degree in patients injecting 30 s was lower than 10 s, the difference was statistically significant (P < 0.05).Conclusion To reduce subcutaneous hemorrhage and local pain caused by injection, the subcutaneous injection of low molecular weight heparin lasting 30 s and pressing for 5 min after injection should be conducted.

Key words: low molecular heparin, local pain, four points oral grading pain score, amount of bleeding

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