集束干预策略在预防重症缺血性脑卒中患者下肢深静脉血栓中的应用  

作　　者：邓秋霞[1] 高岚[1] 王丹丹[1] 张影[1] 贾志芳[2] 曹杰[1] 

机构地区：[1]吉林大学第一医院神经内科,长春130021 [2]吉林大学第一医院流行病学研究室,长春130021

出　　处：《中华现代护理杂志》2013年第33期4119-4123,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨集束干预策略对预防重症缺血性脑卒中患者下肢深静脉血栓（DVT）的影响。方法选择2012年神经内科重症监护病房收治的228例重症缺血性脑卒中患者作为集束干预组，实施集束干预策略，采用包括预防性筛查、体位护理、营养支持和液体管理、保护血管、物理预防、药物预防、被动运动等措施；选择2011年重症监护病房重症缺血性脑卒中患者206例作为对照组，采用常规护理。比较两组患者下肢DVT的发生情况。结果集束干预组仅8例出现下肢DVT，发生率为3．51％，对照组出现49例，发生率为23．79％，两组比较，差异有统计学意义（X2=39．0041，P〈0．01），但是单、双侧肢体瘫痪发生率比较，差异无统计学意义（x2=0．1529，P：0．696）。结论集束干预策略可有效降低重症缺血性脑卒中患者下肢DVT的发生率，值得临床推广使用。Objective To investigate the effect of bundle of care in the prevention of lower extremities deep venous thrombosis ( DVT) among patients with severe ischemic stroke .Methods Two hundred and twenty-eight patients with severe ischemic stroke in the Neurological Intensive Care Unit (NICU) in 2012 were selected as experimental group , and 206 patients with severe acute ischemic stroke in NICU in 2011 as control group.In the experimental group, the patients were treated with bundle of care , which included preventive screening, body position nursing care, nutrition support and liquid management , vascular protection, physical prevention, medicine prevention, passive movement and other measures .And in control group, conventional nursing was applied.The incidence of DVT was observed and compared in two groups .Results There were only 8 patients (3.51%) with lower extremities DVT in the experimental group , and 49 patients (23.79%) with lower extremities DVT in the control group , the difference was statistically significant between the two groups (χ2 =39.004 1,P <0.01).However, there was no statistically significant difference in the incidence of unilateral and bilateral limbs paralysis (χ2 =0.152 9,P=0.696).Conclusions The application of bundle of care can effectively reduce the incidence of deep venous thrombus of lower extremity in patients with severe ischemia stroke.It is worth for clinical use.

关 键 词：卒中 静脉血栓形成 下肢 预防 集束干预 

分 类 号：R473.74[医药卫生—护理学]