目的：观察低分子肝素皮下注射持续时间的循证护理效果。方法选取2013年8-10月在本院心血管内科住院的需皮下注射低分子肝素的患者71例，采用自身对照，通过随机数字表将每例患者的10次皮下注射分为两组：对照组和循证组。循证组通过计算机检索PubMed、 Highwire、 ScienceDirect、中国Cochrane图书馆、中国期刊全文数据库（ CNKI）、万方数据库和Google学术搜索，找出低分子肝素皮下注射最佳注射持续时间，即30 s。对照组低分子肝素皮下注射时间为10 s。注射完即刻采用视觉模拟评分（ VAS）评价注射局部疼痛程度；注射后48 h用透明毫米软尺测量最大出血直径。采用Wilcoxon符号秩和检验对两组的平均疼痛程度及出血直径进行统计检验。结果循证组疼痛程度〔VAS 1.08（0.84）分〕和出血直径〔3.0（2.8） mm〕均低于对照组〔VAS 1.16（0.94）分，4.2（2.8） mm〕（P＜0.05）。结论采用循证护理，低分子肝素皮下注射持续30 s可减轻患者的疼痛程度，并减轻皮下出血。%To evaluate the effect of evidence-based nursing on subcutaneo usinjection duration of lowmo-lecular weigh the parin(LMWH).Methods 71 patients with subcutaneoushe parinin the card iovas culard epartment ofourhos-pital from August to October in 2013 were selected , and the ten heparin injections of each individual were randomly divided into two groups: control group and evidence -based group.The database of PubMed , Highwire, ScienceDirect, China Cochrane Li-brary, CNKI, Wanfang Database and Google Academy were searched for the best available clinical evidence on injection duration of the evidence-based group , namely 30 s.The injection duration of the control group was 10 s.The visual analog scale ( VAS) was used to measure pain intensity immediately after injection .The diameters of bruising areas were assessed at 48 h after injection by using transparent millimetric measuring paper .The pain intensity and bruising area of the two groups were analyzed by using Wilcoxon signed rank test.Results The pain intensity and bruising diameter in the evidence -based group 〔VAS 1.08 (0.84) and 3.0 (2.8) mm respectively〕 were lower than those in the control group 〔VAS 1.16 (0.94) and 4.2 (2.8) mm respec-tively〕 (P<0.05) .Conclusion The evidence-based injection duration (30 s) is proved to be more effective to reduce brui-sing and pain.
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