改良式腹部注射配合精细化护理对降低低分子肝素钙皮下注射不良反应的作用

廖爱红

[摘要] 目的 探討改良式腹部注射配合精细化护理对降低低分子肝素钙皮下注射不良反应的作用。 方法 选取2019年6月至2020年3月我科需要接受低分子肝素钙治疗的患者90例，按照自愿分配原则，其中45例患者接受传统注射方法+常规护理，为对照组;另外45例患者接受改良式腹部注射+精细化护理，为研究组。比较两组患者的不良反应发生率、注射后穿刺点出血周围面积、注射时疼痛程度和护理满意度的变化。 结果 两组局部疼痛、皮下硬结、瘀斑等不良反应发生率比较，研究组显著低于对照组（8.89% vs. 33.33%），差异有统计学意义（P<0.05）;两组注射后穿刺点出血周围面积比较，研究组显著低于对照组，差异有统计学意义（P<0.05）;两组注射时疼痛程度比较，研究组显著低于对照组，差异有统计学意义（P<0.05）;两组护理满意度相比，研究组显著高于对照组，差异有统计学意义（P<0.05）。 结论 为降低低分子肝素钙皮下注射不良反应，给予患者改良式腹部注射配合精细化护理，可有效减少不良反应，降低出血率，应用效果显著，有利于提高患者的满意度，值得推广应用。

[关键词] 低分子肝素钙;皮下注射;不良反应;出血面积

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）12-0180-04

Effect of improved abdominal injection combined with refined nursing on reducing adverse reactions of low molecular weight heparin calcium subcutaneous injection

LIAO Aihong

Department of Gynecology， the First Affiliated Hospital of Gannan Medical University， Ganzhou   341000， China

[Abstract] Objective To explore the effect of improved abdominal injection combined with refined nursing on reducing the adverse reactions of low molecular weight heparin calcium subcutaneous injection. Methods A total of 90 subjects who needed to be treated with low molecular weight heparin calcium in our department from June 2019 to March 2020 were selected in this study. According to the voluntary allocation principle， 45 patients received traditional injection methods+routine care and were regarded as the control group. The other 45 patients received modified abdominal injection+refined care and were regarded as the study group. The incidence of adverse reactions， the bleeding area around the puncture point after injection， the degree of pain during injection， and changes in nursing satisfaction were compared and observed between the two groups. Results The incidence of local pain， subcutaneous induration， ecchymosis， and other adverse reactions was significantly lower in the study group than in the control group（8.89% vs. 33.33%）， and the difference in the data was significant（P<0.05）. The area around the puncture site bleeding of the study group was significantly lower than that of the control group， and the difference in the data was significant（P<0.05）. The observation group had a significantly lower pain degree during injection than the control group， and the difference was relatively significant（P<0.05）. The nursing satisfaction of the study group was significantly higher than that of the control group， and the data were quite different（P<0.05）. Conclusion In order to reduce the adverse reactions of low molecular weight heparin calcium subcutaneous injection， a modified abdominal injection with refined care in patients can effectively reduce adverse reactions and reduce the chance of bleeding. It has a significant application effect， which is beneficial to improve patient satisfaction and is worthy of promotion and application.

[Key words] Low molecular weight heparin calcium; Subcutaneous injection; Adverse reactions; Bleeding area

隨着医疗水平的不断进步，低分子肝素钙与波立维、拜阿司匹林等药物能够预防血管内血栓的形成，降低血栓性疾病发病率，其中低分子肝素该具有疗效显著、生物利用度高等特点，临床应用广泛[1-2]。虽然低分子肝素用药安全性较高，出血及血小板减少的发生率较低，但通常会因注射方法不正确以及患者对其有抵抗心理等因素的影响，导致注射后穿刺部位皮肤易发生出血、瘀斑、局部疼痛等不良反应，严重时可出现硬结和坏死，会增加患者疼痛，严重影响患者康复进程，影响护理满意度，故而如何选择合适的低分子肝素钙注射方法和护理干预成为临床医护人员思考的重点[3]。本研究就改良式腹部注射配合精细化护理对降低低分子肝素钙皮下注射不良反应的作用进行分析和探讨，现报道如下。……