간동맥 화학색전술 후 시술부위의 모래주머니 적용무게에 따른 효과

The Effect of the Weight of a Sandbag on the Sheath Region after a Transcatheter Arterial Chemoembolization

  • 투고 : 2017.05.10
  • 심사 : 2017.06.20
  • 발행 : 2017.06.30

초록

Purpose: This study aimed to investigate the differences in exudate and bleeding incidence and the changes in back pain and discomfort based on the weight of a sand bag applied to the femoral puncture site after hepatic transcatheter arterial chemoembolization. Methods: This quasi-experimental study comprised 82 patients randomly divided into three different groups. Experimental group 1 patients had a 600g sandbag, experimental group 2 patients an 800g sandbag, and control group patients a 1900g sandbag, on femoral access sites post procedure. The three groups of patients were assessed on level of exudate and bleeding and asked about back pain and discomfort at 30, 60, 120, 180 and 240 minutes after the procedure. Results: There were no significant differences in exudate and bleeding between the three groups before and after application of the sandbag post procedure. Both back pain and discomfort were significantly lower in the experimental groups than in the control group. Conclusion: There was no significant effect on bleeding and exudation due to the weight of the sandbag. The lowest level of back pain and discomfort was found in the group with the lightest weight (600 g). Therefore, the use of lighter-weight sandbags to prevent post procedure vascular complications is proposed.

키워드

참고문헌

  1. Bakhshi, F., Namjou, Z., Andishmand, A., Panabadi, A., Bagherinasab, M., & Sarebanhassanabadi, M. (2014). Effects of positioning on patient outcomes after coronary angiography: a single-blind randomized controlled trial. The Journal of Nursing Research, 22(1), 45-50. https://doi.org/10.1097/jnr.0000000000000020
  2. Blankenship, R. D., Clegg, L. A., & Powell, D. T. (1991). Postarteriographic pressure dressing; two type. Critical Care Nurse, 11(5), 92-96.
  3. Chair, S., Fernandez, R., Lui,M., Lopez, V., & Thompson, D. (2008). The clinical effectiveness of length of bed rest for patients recovering from trans-femoral diagnosis cardiac catheterization. International Journal of Evidence-based Healthcare, 6(4), 352-390. https://doi.org/10.1097/01258363-200812000-00002
  4. Chair, S. Y., Li, K. M., & Wong, S. W. (2004) Factors that affect back pain among Hong Kong Chinese patients after cardiac catheterization. European Society of Cardiology, 3(4):279-285.
  5. Christensen, B. V.,Manion,R.V., Iacarella, C. L.Meyer, S. M., Cartland, J. L., Bruhn-Ding, B. J. et al. (1998). Vascular complication after angiography with and without the use of sandbags. Nursing Research, 47(1), 51-53. https://doi.org/10.1097/00006199-199801000-00009
  6. Hahn, S. W. (2002). The effects of exercise therapy and transcutaneous electrical nerve stimulation for the alleviation of low back pain after coronary angiography. Korean Journal of Adult Nursing, 14, 222-232.
  7. Han, J. K. & Cho, K. J. (1999). A comparative study between the application group and non-application group of a sand bag on the surgical region after a pediatric cardiac catheterization. Child Health Nursing Research, 5(3), 340-348.
  8. Hogan-Miller, E., Rustad, D., Sendelbach, S., & Goldenberg, I. (1995). Effects of three methods of femoral site immobilization on bleeding and comfort after coronary angiogram. American Journal of Critical Care, 4(2), 143-148.
  9. Jacobson, K. M., Long, K. H., McMurtry, E. K., Naessens, J.M., & Rihal, C. S. (2007). The economic burden of complications during percutaneous coronary intervention. Quality and Safety in Health Care, 16, 154-159 https://doi.org/10.1136/qshc.2006.019331
  10. Jung, Y. I., Lee, J. H., Hur, E. H., Kwak, I. O., Baek, K. W., Jang, E. M. et al. (2001). The effect of post-procedures on preventing bleeding and increasing comfort in patients received coronary angiography. Journal of Korean Clinical Nursing Research, 7(2), 67-88.
  11. Juran, N.B., Rouse, C. L., Smith, D. D., O'Brien, M. A., DeLuca, S. A., & Sigmon, K. (1999). Nursing intervention to decrease bleeding at the femoral access site after percutaneous coronary intervention. American Journal of Critical Care, 8(5), 303-313.
  12. Manoukian, S. V. (2010). The relationship between bleeding and adverse outcomes in ACS and PCI: pharmacologic and nonpharmacologic modification of risk. Journal of Invasive Cardiology, 22, 132-141.
  13. May, O., Schlosser, H., & Skytte, L. (2008). A randomized trial assessing the influence of lying still or being allowed to move in the observation period following coronary angiography using the femoral approach. Journal of Interventional Cardiology, 21(4), 347-349. https://doi.org/10.1111/j.1540-8183.2008.00359.x
  14. Merriweather, N. & Sulzbach-Hoke, L. M. (2012). Managing risk of complications at femoral vascular access sites in percutaneous coronary intervention. Critical Care Nurse, 32(5), 16-29. https://doi.org/10.4037/ccn2012123
  15. Ministry of Health and Welfare, Korea Central Cancer Registry (2015). Annual report of cancer statistics in Korea in2013. Ministry of Health andWelfare,Korea Central Cancer Registry.
  16. Nam, S. H. & Kim. Y. J. (2013). Effect of bed side exercising on back pain and bleeding complications after transcatheter arterial chemoembolization. Korean Journal of Adult Nursing, 25(4), 400-408. https://doi.org/10.7475/kjan.2013.25.4.400
  17. Nikolsky, E., Mehran, R., Halkin, A., Aymong, E. D., Mintz, G. S., Lasic, Z. et al. (2004). Vascular complications associated with arteriotomy closure devices in patients undergoing percutaneous coronary precedures; a meta-analysis. Journal of the American College of Cardiology, 44(6), 1200-1209. https://doi.org/10.1016/j.jacc.2004.06.048
  18. Oh, C.M.,Won, Y. J., Jung, K.W., Kong, H. J., Cho, H., et al. (2016). Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Official Journal of Korean Cancer Association, 48(2), 436-450. https://doi.org/10.4143/crt.2016.089
  19. Olson, N. C. (2016). Comparison of head elevation protocols following femoral artery sheath removal after coronary angiography. Critical Care Nurse, 36(3), 20-34. https://doi.org/10.4037/ccn2016560
  20. Rein, A., Zhu, Y., Parkhurst, M., Ranmsburg, S., Bennett, G., Andes, L., et al. (1995). Positioning postoutpatient cardiac catheterization. Progress in Cardiovascular Nursing, 10(4), 4-10.
  21. Shoulders-Odom, B. (2008). Management of patients after percutaneous coronary interventions. Critical Care Nurse, 28, 26-41.
  22. Statistics Korea (2015). Causes of Death Statistics in 2014. Statistics Korea.
  23. Sulzbach-Hoke, L. M., Ratcliffe, S. J., Kimmel, S. E., Kolansky, D. M., & Polomano, R. (2010). Predictors of complications following sheath removal with percutaneous coronary intervention. Journal of Cardiovascular Nursing, 25, E1-E8.
  24. Turi Z. (2010). Optimal femoral access prevents complications. Cardiac Intervention Today, January/February, 35-38
  25. Valji, K. (2006). Vascular and interventional radiology. 2nd ed, 295-301. Philadelphia, Pa. : Saunders Elsevier.
  26. Wang, S. L., Redeker, N. S., Moreyra, A. E., & Diamond, M. R. (2001). Comparison of comfort and local complications after cardiac catheterization. Clinical Nursing Research, 10(1), 29-39. https://doi.org/10.1177/c10n1r4
  27. Yilmaz, E., Gurgun, C., & Dramali, A. (2007).Minimizing short-term complications in patients who have undergone cardiac invasive procedure: a randomized controlled trial involving position change and sandbag. The Anatolian Journal of Cardiology, 7(4), 390-397.
  28. Yun, S. Y. (2008). Transarterial chemoembolization patients with liver cancer. Nursing Science, 20(1), 11-23.