Comparative Study Of Low Molecular Weight Heparin Calcium Injection By Different Methods After PCI In Patients With Coronary Heart Disease

ObjectiveTo investigate different pressing methods and Massage before injection on adverse effect caused by subcutaneous injection of low molecular weight heparin(LMWH)in coronary heart disease patients after PCI in a specific period of time("triple anticoagulant treatment period"),in order to find the optimum method of injection and reduce the occurrence of adverse reactions like subcutaneous hemorrhage,pain and other adverse reactions,To Improve the medication compliance of patients,to provide more scientific and reliable basis for clinical nurses.MethodsFrom July to December in 2016,we select 400 coronary heart disease patients after PCI who were going to receive the subcutaneous injection of low molecular weight heparin calcium in the Department of three level of first-class comprehensive hospital,The factorial design was used,1 factors are: before injection massage,the level of the 2 are: massage before injection,no massage before injection.2 factors for the pressing method,the level of the following are: pinching hemostatic method(that is,after the needle,the injection site to maintain skin wrinkle for 2min),without pressing,pressing for 5 min,pressing for 10 min.The patients were randomly divided into A-H group,8 groups,each group of 50 cases.group A:massage before injection and pinching hemostatic method,group B:no massage before injection and pinching hemostatic method)group C:massage before injection without pressing,group D:no massage before injection without pressing,group E:massage before injection and pressing for 5 min,group F:no massage before injection and pressing for 5 min,group G:massage before injection and pressing for 10 min,group H:no massage before injection and pressing for 10 min.Immediately after the injection,numerical rating scale(NRS)was used to evaluate the degree of local pain caused by injection;48 hours after injection,the most maximum subcutaneous haemorrhage diameter was measured by transparent millimeter tape,and analyses the influence of pre injection massage and different pressing methods of subcutaneous hemorrhage and local injection pain,to find the optimal injection method.Results1.Local subcutaneous hemorrhage:Massage before injection and pressing methods had no interaction effect on the diameter of subcutaneous hemorrhage(P>0.05),Massage before injection had no significant major effect on the diameter of subcutaneous hemorrhage(P>0.05).The main effect of different pressing methods on the diameter of subcutaneous hemorrhage was significant(P<0.05).There was no significant difference in the degree of subcutaneous bleeding with massage before injection or not(P>0.05).With or without massage before injection,There were significant differences of subcutaneous hemorrhage between pinching hemostatic mothed,without pressing,pressing for 5 min,pressing for 10 min(P<0.05).Pressing for 5 min and pressing for 10 min caused smaller diameter of subcutaneous hemorrhage than no pressing and pinching hemostatic mothed in the case of any injection duration(P<0.05);pressing for 5 min and pressing for 10 min were not significantly different in the diameter of subcutaneous hemorrhage in the case of any injection duration(P>0.05).2.The degree of local pain of injection: there was no interaction between the massage before injection and different pressing methods on the degree of local pain(P>0.05).Before injection,the main effect of local pain was significant(P<0.05).The main effect of different pressing methods on the local pain was not significant(P>0.05).There were significant differences in the degree of pain in the injection before and after the massage,and the difference was statistically significant(P< 0.05).Under the different pressure method,the degree of local pain before injection was lower than that before injection,and the difference was statistically significant(P<0.05).There was no significant difference in the degree of local pain between the two groups with the method of massage,no press,press 5 min and 10 min,and the difference was not statistically significant(P>0.05).3.There were significant differences in the diameter distribution of subcutaneous bleeding between the two groups(P <0.05);There was a correlation between the age of patients and the diameter of subcutaneous hemorrhage(P <0.05).Conclusions1.Application of low molecular weight heparin calcium in patients with coronary heart disease(CHD)after PCI surgery in a specific period of time(triple anticoagulation therapy): massage before injection can reduce the degree of local pain;Press 5 min after injection can reduce the incidence of local subcutaneous hemorrhage;the use of massage before injection,injection after pressing 5 min can reduce the incidence of adverse reactions after subcutaneous injection.2.Application of low molecular weight heparin calcium in patients with coronary heart disease(CHD)after PCI surgery in a specific period of time(triple anticoagulation therapy): The severity of local subcutaneous hemorrhage in female patients was higher than that in male patients;There was a positive correlation between the age of patients and the diameter of local subcutaneous hemorrhage.