老年卧床患者下肢深静脉血栓防控指引的制订及应用  

Formulation and application of prevention and control guideline for deep venous thrombosis in lower extremities bedridden elderly patients

作　　者：徐琴鸿[1] 姜建帅[2] 叶智学 张燕逸 林郁清[3] Xu Qinhong;Jiang Jianshuai;Ye Zhixue;Zhang Yanyi;Lin Yuqing(Department of Nursing,Ningbo First Hospital,Ningbo 315010,China;Department of General Surgery,Ningbo First Hospital,Ningbo 315010,China;Emergency Ward,Ningbo First Hospital, Ningbo 315010,China)

机构地区：[1]浙江省宁波市第一医院护理部,315010 [2]浙江省宁波市第一医院普外科,315010 [3]浙江省宁波市第一医院急诊病房,315010

出　　处：《中华现代护理杂志》2018年第30期3609-3612,共4页Chinese Journal of Modern Nursing

基　　金：宁波市第一医院院级课题(2014yj013).

摘　　要：目的构建老年卧床患者下肢DVT防控指引,并探讨其应用效果。方法通过文献检索及访谈病区医护人员、回顾性查阅老年卧床患者并发DVT病例,分析老年卧床患者DVT防控中存在的问题。依据循证实践指南制定防控指引,通过建立老年卧床患者DVT防控团队及流程,实施Caprini和Padua血栓风险评估、制作相关健康指导视频及质量控制等措施。于2017年2月开始开展老年卧床患者DVT防控指引的临床应用。比较实施前(2016年5月-2017年1月,n=112)和实施后(2017年2~11月,n=99)老年卧床患者DVT发生情况及血液淤滞发生情况。结果实施防控指引后,老年卧床患者血液淤滞检出率由6.3%(7/112)升至15.2%(15/99),而DVT发生率由8.9%(10/112)降至2.0%(2/99),两组差异有统计学意义(x^2值分别为4.458、4.676;P<0.05)。结论基于DVT预防管理指南的防控指引可降低住院老年卧床患者DVT发生的风险。Objective To formulate a prevention and control guideline for deep venous thrombosis (DVT)in lower extremities in bedridden elderly patients and to explore its effects.Methods The problems existing in prevention and control of DVT in bedridden elderly patients were analyzed by search for literature, interviewing medical and nursing staff in the ward and reviewing DVT cases in bedridden elderly patients.The prevention and control guideline was formulated based on the evidence-based practice guideline.Relevant health videos were made and quality control measures were formulated by building DVT prevention and control teams and processes for bedridden elderly patients and adopting Caprini's and Padua's risk assessment tools.The prevention and control guideline was put into clinical use since February 2017.The incidence of DVT and blood stasis in bedridden elderly patients before (from May 2016 to January 2017,n=112)and after(between February and November 2017,n=99)the implementation of the guideline.Results After the prevention and control guideline was implemented,the positive rate of blood stasis in the bedridden elderly patients rose from 6.3% (7/112)to 15.2%(15/99),while the incidence rate of DVT dropped from 8.9%(10/112)to 2.0%(2/99)(X^2=4.458, 4.676;P<0.05).Conclusions The prevention and control guideline based on the DVT prevention and management guideline can reduce the risks of DVT in bedridden elderly inpatients.

关 键 词：老年人 深静脉血栓形成 卧床患者 预防 

分 类 号：R473[医药卫生—护理学]