Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Subkütan Heparin Uygulamalarında Beden Kitle İndeksine Göre Ekimoz ve Hematom Farklılıklarının Değerlendirilmesi
The Evaluation of the Hematoma and Ecchymosis Differences According to Body Mass Index in the Subcutaneous Heparin Administration
Yadigar ORDUa, Nurcan ÇALIŞKANb
aÇankırı Karatekin Üniversitesi Eldivan Sağlık Hizmetleri Meslek Yüksekokulu, Sağlık Bakım Hizmetleri Bölümü, Evde Hasta Bakım Programı, Çankırı, TÜRKİYE
bGazi Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Hemşirelik Esasları ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2020;12(3):371-7
doi: 10.5336/nurses.2020-73648
Article Language: TR
Full Text
ÖZET
 Amaç: Subkütan düşük molekül ağırlıklı heparin uygulanan hastalarda, beden kitle indeksine göre kol ve karın bölgesinde ekimoz ve hematom farklılıklarının değerlendirilmesidir. Gereç ve Yöntemler: Araştırma, bir devlet hastanesinin göğüs hastalıkları kliniğinde, KOAH tanısı ile enoksaparin sodyum 0,6 mL 1x1 subkütan şeklinde tedavi alan hastalar ile yapılmış tanımlayıcı bir çalışmadır. Örneklemi 30 kadın, 30 erkek olmak üzere 60 hasta oluşturmaktadır. Verilerin toplanmasında, hasta tanılama formu ve hasta izlem formu kullanılmıştır. Çalışmaya başlamadan önce etik kurul ve kurum izni alınmıştır. Katılımcılar, her grupta 15 hasta olmak üzere zayıf, normal kilolu, fazla kilolu ve obez olmak üzere ayrılmıştır. Enjeksiyonlar, sağ/sol ve kol/karın bölgelerine 4 defa uygulanmıştır. Enjeksiyon sonrasında 48 ve 72. saatlerde ekimoz ve hematom bulguları değerlendirilmiştir. Bulgular: Kol bölgesinde 48. Saatte ekimoz ve hematom gelişimi gözlenirken; 72. saatte ise hematom gelişiminin karın bölgesine göre daha fazla olduğu ve farkın istatistiksel olarak anlamlı olduğu belirlenmiştir. Zayıf bireylerde 72. saatte kol bölgesinde ekimoz; 48. saatte ise karın bölgesinde hematom gelişiminin diğer gruplara göre daha fazla olduğu ve farkın istatistiksel olarak anlamlı olduğu saptanmıştır (p<0,05). Sonuçlar: Subkütan heparin enjeksiyonlarının klinik uygulamalarında öncelikle karın bölgesinin tercih edilmesi, bölgenin kullanımının yaygınlaştırılması ve çalışmada beden kitle indeksine göre zayıf bireylerde daha fazla komplikasyon gelişmesine yönelik kanıt temelli çalışmaların yapılması önerilmektedir.

Anahtar Kelimeler: Ekimoz; hematom; subkütan heparin; subkütan uygulama
ABSTRACT
 Objective: The aim of this study is to evaluate the differences in ecchymosis and hematoma in the arm and abdomen according to body mass index in patients receiving subcutaneous low molecular weight heparin. Material and Methods: The study is a descriptive study conducted with patients receiving COPD in the chest diseases clinic of a state hospital receiving Enoxaparin Sodium 0.6 mL 1x1 subcutaneously. The sample consisted of 60 patients (30 female and 30 male). Patient Identification Form and Patient Follow-up Form were used to collect the data. Before starting the study, Ethics Committee and institution permission was obtained. Patients; 15 of them are underweight, 15 of them are normal weight, 15 are overweight and 15 are obesity. The injections were administered 4 times to the right/left and arm/abdomen. Ecchymosis and hematoma findings were evaluated at 48 and 72 hours after injection. Results: It was determined that ecchymosis and hematoma in the arm region at 48th hour and hematoma development at 72th hour were higher than the abdominal region and the difference was statistically significant. It was found that ecchymosis in arm region at 72 hours and hematoma in abdominal region at 48 hours were higher than the other groups and the difference was statistically significant (p<0.05). Conclusion: In clinical applications of subcutaneous heparin injections, it is recommended that the abdominal region be preferred, the use of the region should be expanded, and evidence-based studies for the development of more complications in weak individuals than body mass index are recommended.

Keywords: ecchymosis; hematoma; subcutaneous heparin; subcutaneous application
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