【摘要】 目的优化皮下注射低分子肝素的方法,降低患者皮下青紫及注射疼痛。方法对皮下注射低分子肝素流程中的4个因素及对应的3个水平按正交设计L9(34)分组;选取冠状动脉支架植入术后使用低分子肝素患者180例,随机分配进入各试验方案,采用9种不同方案进行皮下注射,观察患者皮下青紫发生情况及疼痛程度。结果注射角度、注射速度、按压时间为主要因素(均P<0.05),注射部位为次要因素(P>0.05)。皮下注射低分子肝素的优势方案为:注射时提捏皮肤90°进针,持续注射10s后等待10s,注射后无需按压。对于注射部位建议选择脐周左右10cm,上下5cm,避开脐周1cm,每针间隔2cm。结论应用优势方案皮下注射低分子肝素,可减少皮下青紫及减轻注射疼痛。更多还原

【Abstract】 Objective To optimize the process of subcutaneous injection of low molecular heparin,and to reduce bruising and pain intensity.Methods The process of subcutaneous injection of low molecular heparin had 4variables at 3different levels.We conducted a Taguchi experiment with a L9(34)orthogonal array(9tests,4variables,3levels).A total of 180 patients after coronary stenting were randomized into the nine tests to receive subcutaneous injection of low molecular heparin,then bruising and pain intensity were measured.Results The injection angle,speed and pressing time were principal factors(P<0.05 for all),while the injection site was secondary factor(P>0.05).The optimal protocol for subcutaneous injection of low molecular heparin was:the needle penetrated into the skin with 90 degree angle;the injection lasted 10 seconds,and then waited for 10 seconds before removal of the needle;and pressing is not needed after removal of the needle.The injection could be given 1cm width away from the umbilicus,but within 5-10 cm width from that area;and new injections should be given 2cm away from the last injection site.Conclusion Using the optimal protocol for subcutaneous injection of low molecular heparin can reduce bruising and relieve procedural pain.更多还原