Application effect of ACT monitor cooperated with special nursing during PCI perioperation

Abstract

Objective To monitor the evaluation of heparin dose in activated clotting time (ACT) during PCI perioperation, and explore its application in clinical care. Methods Totally 327 patients with coronary angiography, PTCA and stent implantation, using heparin to anticoagulating simultaneously in conduit room of the 306th Hospital of PLA from April 2014 to April 2015. By ACT monitoring and preoperative nursing visit, we collected patients′ risk factors, and made operation plans; patients were assigned to five groups by the stage of age, and ten year-old was taken as a stage. ACT was closely observed in the operation, and the risk situation of patients was also observed; after operation, specific guidance was taken. Results There were patients with substandard ACT in each group after operation, and needed additional heparin. 71 cases of patients with preoperative application of tirofiban, their postoperative ACT were within the target range 200-250 s; among 256 patients without preoperative application of tirofiban, there were 41 patients whose ACT value does not reach the required target value and needed additional heparin, wherein the incidence rate of substandard VCT value of 55-64 year-old group was the highest and was 20%. Eight cases without preoperative application of tirofiban, had sheath pipe pulled out because of errhysis in femoral artery sheath pipe puncture after operation, but their VCT value was within the target range of target value. All patients had no intraoperative and postoperative stroke, bleeding and thrombosis, etc. Conclusions ACT monitoring and effective coordination of care, can ensure the safety of heparin used in interventional procedures. Key words: Heparin; Whole blood coagulation time; Nursing; Percutaneous coronary intervention