不同体位对下肢动脉硬化闭塞患者微循环、疼痛及舒适度的影响
摘要
目的探讨两种不同体位(抬高下肢和下垂下肢)对下肢动脉硬化闭塞(LEAD)患者氧分压、疼痛和舒适度的影响。方法选取2018年7月至2019年4月就诊于郑州大学第一附属医院血管外科的下肢动脉硬化闭塞患者100例,采用随机数表法分成对照组和观察组,各50例。对照组采取抬高下肢体位,观察组采取下垂下肢体位,对比两组患者患肢的经皮氧分压(TcPO_2)、疼痛程度(VAS疼痛量表)和舒适度(线性视觉模拟评分)。结果干预前两组患者氧分压、疼痛、舒适度得分比较,差异无统计学意义(均P>0.05);干预后两组上述指标均优于干预前,且观察组氧分压高于对照组,疼痛、舒适度评分低于对照组,差异有统计学意义(均P<0.05)。结论下肢下垂体位利于提高LEAD患者氧分压,改善微循环,减轻疼痛,提高舒适度。
引文
[1] KOSHIKAWA M,IKEDA U.Arteriosclerosis obliterans[J].Nippon Rinsho,2010,68(5):926-929.
[2] MIYAHARA T,SUHARA M,NEMOTO Y,et al.Long-term results of treatment for critical limb ischemia[J].Ann Vasc Dis,2015,8(3):192-197.
[3] PASTERNAK R C,CRIQUI M H,BENJAMIN E J,et al.Evaluation and treatment of patients with lower extremity peripheral artery disease:consensus definitions from peripheral academic research consortium( PARC)[J].J Am Coll Cardiol,2015(9):931-941.
[4] 张川林,赵渝,刘丽萍,等.下肢动脉硬化闭塞术后患肢抬高体位对足部血流灌注的影响[J].护理学杂志,2015,30(12):28-30.
[5] 孙艳,崔飞飞,张龙,等.不同体位下局部持续受压对人体皮肤血流灌注及温度的影响[J].中华烧伤杂志,2013,29(1):67-69.
[6] 李乐之,路潜.外科护理学[M].北京:人民卫生出版社,2012:553-557.
[7] RICH K.Effect of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revas-cularization:a piot study[J].J Vasc Nurs,2002,20(4):125-137.
[8] 张川林,牟绍玉,赵渝,等.不同体位对下肢动脉硬化闭塞患者患肢微循环及主观感受的影响[J].护理学杂志,2015,30(21):25-28.
[9] 中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南(上)[J].中国血管外科杂志(电子版),2015,7(3):145-151.
[10] DENG W,DONG X,ZHANG Y,et al.Transcutaneous oxygen pressure(TcPO2):a novel diagnostic tool for peripheral neuropathy in type2 diabetes patients[J].Diabetes Res Clin Pract,2014,105(3):336-343.
[11] 彭秀晴,郭明珂,孙福振,等.肾癌术后择时生物治疗对患者舒适度的影响[J].中华护理杂志,2010,45(7):618-619.
[12] 王晓颖.下肢动脉硬化闭塞症介入治疗的护理[J].齐齐哈尔医学院学报,2011,32(3):472-473.
[13] 张培华.临床血管外科[M].北京:科学出版社,2003:198-199.
[14] 吴蠡荪.微循环与常见心血管疾病[J].蛇志,2012,24(2):232.
[15] Norgren L.Inter-society consensus for the management of peripheral arterial disease (TASC II)[J].J Vasc Surg,2007,45:151-160.
[16] 张永玲,赵晓雯.下肢动脉硬化闭塞患者介入治疗前后生存质量研究[J].哈尔滨医科大学学报,2018,52(3):292-296.
[17] KAWASAKI T,MATSUO K,MASUMOTO K,et al.The effect of different positions on lower limbs skin perfusion pressure[J].Indian J Plast Surg,2013,46(3):508-512.
[18] RICH K.Effects of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revascularization:A pilot study[J].J Vasc Nurs,2002,20(4):125-135.
[19] SHINOZAKI N.Effect of body position on skin perfusion pressure in patients with severe peripheral arterial disease[J].Circ J,2012,76(12):2863-2866.
[20] 田牛.实用临床微循环学[M].北京:军事科学出版社,1989:456.
[21] 蔡敏,李宏宇,袁彦.经皮氧分压在糖尿病足确定截肢平面中的应用和评价[J].中国矫形外科杂志,2013,21(5):438-441.
[22] 张川林.不同体位对下肢动脉硬化闭塞患者足部微循环影响的研究[D].重庆:重庆医科大学,2016.
[2] MIYAHARA T,SUHARA M,NEMOTO Y,et al.Long-term results of treatment for critical limb ischemia[J].Ann Vasc Dis,2015,8(3):192-197.
[3] PASTERNAK R C,CRIQUI M H,BENJAMIN E J,et al.Evaluation and treatment of patients with lower extremity peripheral artery disease:consensus definitions from peripheral academic research consortium( PARC)[J].J Am Coll Cardiol,2015(9):931-941.
[4] 张川林,赵渝,刘丽萍,等.下肢动脉硬化闭塞术后患肢抬高体位对足部血流灌注的影响[J].护理学杂志,2015,30(12):28-30.
[5] 孙艳,崔飞飞,张龙,等.不同体位下局部持续受压对人体皮肤血流灌注及温度的影响[J].中华烧伤杂志,2013,29(1):67-69.
[6] 李乐之,路潜.外科护理学[M].北京:人民卫生出版社,2012:553-557.
[7] RICH K.Effect of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revas-cularization:a piot study[J].J Vasc Nurs,2002,20(4):125-137.
[8] 张川林,牟绍玉,赵渝,等.不同体位对下肢动脉硬化闭塞患者患肢微循环及主观感受的影响[J].护理学杂志,2015,30(21):25-28.
[9] 中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南(上)[J].中国血管外科杂志(电子版),2015,7(3):145-151.
[10] DENG W,DONG X,ZHANG Y,et al.Transcutaneous oxygen pressure(TcPO2):a novel diagnostic tool for peripheral neuropathy in type2 diabetes patients[J].Diabetes Res Clin Pract,2014,105(3):336-343.
[11] 彭秀晴,郭明珂,孙福振,等.肾癌术后择时生物治疗对患者舒适度的影响[J].中华护理杂志,2010,45(7):618-619.
[12] 王晓颖.下肢动脉硬化闭塞症介入治疗的护理[J].齐齐哈尔医学院学报,2011,32(3):472-473.
[13] 张培华.临床血管外科[M].北京:科学出版社,2003:198-199.
[14] 吴蠡荪.微循环与常见心血管疾病[J].蛇志,2012,24(2):232.
[15] Norgren L.Inter-society consensus for the management of peripheral arterial disease (TASC II)[J].J Vasc Surg,2007,45:151-160.
[16] 张永玲,赵晓雯.下肢动脉硬化闭塞患者介入治疗前后生存质量研究[J].哈尔滨医科大学学报,2018,52(3):292-296.
[17] KAWASAKI T,MATSUO K,MASUMOTO K,et al.The effect of different positions on lower limbs skin perfusion pressure[J].Indian J Plast Surg,2013,46(3):508-512.
[18] RICH K.Effects of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revascularization:A pilot study[J].J Vasc Nurs,2002,20(4):125-135.
[19] SHINOZAKI N.Effect of body position on skin perfusion pressure in patients with severe peripheral arterial disease[J].Circ J,2012,76(12):2863-2866.
[20] 田牛.实用临床微循环学[M].北京:军事科学出版社,1989:456.
[21] 蔡敏,李宏宇,袁彦.经皮氧分压在糖尿病足确定截肢平面中的应用和评价[J].中国矫形外科杂志,2013,21(5):438-441.
[22] 张川林.不同体位对下肢动脉硬化闭塞患者足部微循环影响的研究[D].重庆:重庆医科大学,2016.