改进后的技术可减少传统无触摸静脉移植物采集技术的下肢并发症:单中心回顾性历史对照研究。

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of Multidisciplinary Healthcare Pub Date : 2024-11-20 eCollection Date: 2024-01-01 DOI:10.2147/JMDH.S492144
Teng-Yue Zhao, Bing-Jie Wang, Jiang Liu, Chu Liu, Ji-Qiang Bu, Yu Liu, Fang Yan, Wen-Li Zhang, Zi-Ying Chen, Yu-Ming Wu
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引用次数: 0

摘要

目的:在冠状动脉旁路移植术中采用无接触技术采集大隐静脉(GSV),大大提高了临床通畅率。尽管有这些优点,但这种移植物可能会导致患者下肢出现并发症。本研究旨在通过采用无接触式采集技术的改进方案,评估下肢并发症的发生率:本研究的历史对照组包括2018年8月至2020年4月期间在我院接受冠状动脉旁路移植术(CABG)的患者,在符合伦理标准的情况下,采用无接触技术采集GSV。干预组包括接受 CABG 并在 2020 年 5 月至 2022 年 6 月期间采用优化的无接触技术采集 GSV 的患者。为减少下肢并发症,对技术进行了调整,包括限制电烧的使用、尽量减少血管外组织的保留、术后放松弹力加压绷带以及抬高下肢。这些措施旨在降低术后下肢并发症的发生率,如疼痛、麻木、水肿、渗出和延迟愈合。对两组患者术后并发症的发生情况进行了细致的记录、比较和分析:结果:采用优化的无触摸技术后,接受非泵 CABG 手术的患者术后下肢切口并发症的发生率明显降低(P < 0.05):本研究结果证实,应用优化的无触摸技术采集 GSV 可显著降低接受 CABG 患者术后下肢并发症的发生率。这些结果凸显了采用这种优化技术并将其纳入临床方案的重要性,强调了它在提高患者护理效果方面的关键作用。
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Improved Technique Reduce Lower Limb Complications After the Traditional No-Touch Technique for Vein Graft Harvesting: A Single-Center Retrospective Historical Controlled Study.

Objective: The employment of the no-touch technique in harvesting the great saphenous vein (GSV) for coronary artery bypass grafting has been associated with a significant improvement in clinical patency rates. Despite these advantages, such grafts may predispose patients to complications in the lower limbs. This study endeavors to evaluate the incidence of complications in the lower extremities by deploying an enhanced protocol for the no-touch harvesting technique.

Methods: The historical control group in this study included patients who underwent coronary artery bypass grafting (CABG) with the no-touch technique for GSV harvesting at our institution from August 2018 to April 2020, in compliance with ethical standards. The intervention group consisted of patients who received CABG and were subjected to an optimized no-touch technique for GSV harvesting from May 2020 to June 2022. Technical modifications were applied to reduce lower limb complications, including limited use of electrocautery, minimization of extravascular tissue preservation, relaxation of postoperative elastic compression bandages, and elevation of the lower extremities. These measures aimed to decrease the incidence of postoperative lower limb complications, such as pain, numbness, edema, exudation, and delayed healing. The occurrences of postoperative complications were meticulously documented, compared, and analyzed between the two groups.

Results: The adoption of the optimized no-touch technique resulted in a significant decrease in the incidence of postoperative lower extremity incisional complications among patients subjected to off-pump CABG (p < 0.05).

Conclusion: The results of this study substantiate that the application of an optimized no-touch technique to harvest the GSV significantly diminishes the incidence of postoperative lower limb complications in patients receiving CABG. These results highlight the importance of adopting and integrating this optimized technique into clinical protocols, emphasizing its critical role in advancing patient care outcomes.

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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
期刊介绍: The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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