Study On The Relationship Between The Pressing Time And Bruising At The Injection Site Associated With Subcutaneous Low Molecular Weight Heparin In Patients With Deep Vein Thrombosis

ObjectiveBy Comparing four different local pressing time on the influence of the bruising at the injection site after subcutaneous injection of low molecular weight heparin,the thesis aims at finding out the least number and smallest bruise of the pressing time,which helps to alleviate the patients’ pain,increase the trust of patients to the nurse,improve the compliance of treatment,the harmonious relationship between nurses and patients,and to provide guidance for clinical nursing work,therefore,make the clinical work easy to be implemented.MethodsThis study was conducted on 25 patients with deep vein thrombosis.They were administered heparin subcutaneously every 12 hours.Each patient received twelve injections by using four different methods,a total of 300 cases.Method A: pressing for 10 minutes after injection;method B: pressing for 5 minutes after injection;method C: pressing for 3 minutes after injection;method D: don’t press after injection.The number and size of bruising at the injection site were measured at 48 hours after each injection.By choosing patients with deep vein thrombosis in vascular surgery,a general hospital in Liaoning,from August 2014 to March 2015,as the research objects,the paper determines the inclusion criteria and exclusion criteria,in 25 cases,each of the patients were Q12 h subcutaneous injection of low molecular weight heparin and accept four different pressing time of low molecular weight heparin subcutaneous injection(method A: press the 10 minutes after injection;the method B: press 5 minutes after injection;method C: three minutes after the injection pressure and method D: don’t press after injection),each patient with 12 times subcutaneous injection,A total of 300 cases.All subcutaneous injections are performed by the same nurse.With blind method,48 hours after each injection,it is observed and recorded by another nurse if there is any subcutaneous bleeding at the injection site,electronic digital caliper with accuracy of 0.01 mm diameter measuring subcutaneous bleeding and bleeding area calculation.Meanwhile,SPSS 17.0 statistical software will be used for data analysis.Results1.Four types of pressing time after injection of the subcutaneous hemorrhage rate were 34.7%,57.3%,70.7% and 34.7% respectively,and the differences were mostly in statistical aspect(?2= 24.728,P < 0.05).Method A(injection pressure after 10 minutes)and method B(injection pressure for 5 minutes),C(press the 3 minutes after injection),D(not after injection pressure),the difference was statistically significant(P < 0.008);Method B,the method of C and D three differences between show no statistical significance(P > 0.008).2.Four types of pressing time after injection site,mean value of subcutaneous bleeding area rank 112.6,145.7,175.0 and 168.4 respectively,and differences were statistically significant(?2= 25.706,P < 0.05).Compared with other three methods,the difference showed in Method A was statistically significant(all P < 0.008);Method B,the method of C and D three differences shows no statistical significance(P > 0.008).3.Elderly patients(age greater than 60 years old)and patients after sex and low molecular weight heparin injection at the injection site illustrate no connection between subcutaneous hemorrhage(P >0.05,?2 were 1.996,?2=0.308);Four groups of patients with body mass index(BMI)the incidence of subcutaneous hemorrhage were 25.0%,59.1%,56.3% and 25.0% respectively.Body mass index(BMI)and low molecular weight heparin injection at the injection site after subcutaneous bleeding incidence correlate to some extent(?2=11.156,p=0.011),Pearson contingency coefficient is 0.189.4.The elderly patients(more than 60 years old or not),patients with gender and low molecular weight heparin injection at the injection site after subcutaneous bleeding area show unrelated bonding(all P > 0.05,Z=-1.207 and-1.839).Patients with different BMI groups after injection of low molecular weight heparin injection site area of the mean rank of subcutaneous bleeding were 92.6,148.1,148.2 and 261.4,depicting statistically significant difference(?2 = 27.212,P < 0.05),body mass index of 28.0 or group with three other patients with subcutaneous bleeding area has a statistically significant difference(P < 0.008).Conclusions1.By pressing for 10 minutes after subcutaneous injection of low molecular weight heparin,it can decrease the rate of injection site subcutaneous bleeding,reduce subcutaneous bleeding area,which is the best pressing time after injection of low molecular weight heparin.2.It shows no correlation among the elderly patients(more than 60-year-old or not),patients with different gender,low molecular weight heparin injection after subcutaneous hemorrhage rate and bleeding area.Body mass index(BMI)and low molecular weight heparin injection site after subcutaneous injection associate with incidence of bleeding,and Pearson contingency coefficient is 0.189;while a body mass index is greater than or equal to 28.0,the area of subcutaneous hemorrhage in patients tend to increase.