人工关节置换后深静脉血栓形成的预防与护理  

Prevention and nursing of deep vein thrombosis after artificial joint replacement

作　　者：穆彦丽 邵艳[1] 杨克侠[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院骨科,233004

出　　处：《中华全科医学》2014年第11期1850-1852,共3页Chinese Journal of General Practice

摘　　要：目的探讨人工关节置换术患者术后深静脉血栓形成的预防与护理方法。方法回顾性分析2013年1月—2014年2月骨科收治的80例下肢关节置换患者的临床资料。通过加强入院宣教,术前风险评估并采取针对性的预防措施,术后密切观察患肢深静脉血流情况、指导协助患者早期功能锻炼、予以相关药物预防等一系列护理工作,从而预防深静脉血栓形成。结果 80例患者术后发生5例深静脉血栓,3例髂静脉血栓,2例腘静脉血栓,预防深静脉血栓形成有效率达93.75%;DVT患者使用低分子肝素钙4000 U皮下注射治疗后,B超证实血栓消失。无患者并发肺栓塞,死亡0例。结论深静脉血栓是下肢人工关节置换患者常见的并发症,必须重视对人工关节置换患者的预防与护理工作。出入院宣教,术前评估、预防药物、术后早期功能锻炼、相关抗凝镇痛药物的应用、优质的护理服务等各项措施的有机结合有效地预防了深静脉血栓的形成,减少肺栓塞等严重并发症,降低了病死率,提高了患者的生存质量。Objective To explore the preventive measures and nursing principles of the deep vein thrombosis （DVT） after artificial joint replacement. Methods The clinical information of 80 cases of lower limb joints replacement surgery between January 2013 and February 2014 were analyzed retrospectively. The preventive measures performed in patients included： strengthening admission propaganda and education, preoperative risk assessments and the corresponding prevention measures, postoperative observation of hmb deep vein blood flow situation, guiding and assisting patients doing early functional exercise,and prevention drugs administration. Results There were 5 cases of deep vein thrombosis,3 cases of iliac vein thrombosis and 2 cases of popliteal vein thrombosis, the efficient prevention of deep vein thrombosis achieved a rate of 93.75%. Ultrasound examination found that the thrombosis was disappeared in DVT patients after taking the treat- ment of subcutaneous injection with 4000u low molecular heparin calcium. There was no case with pulmonary embolism or death case. Conclusion The deep vein thrombosis is the main complication of lower limb joints replacement surgery, more prevention and nursing should be paid attention to patients with joints replacement surgery. The combination of the admission propaganda and education, preoperative evaluation, prevention drugs administration, early postoperative function exercise, application of related anticoagulation analgesic drug and effective nursing care can effectively prevent the forma- tion of deep vein thrombosis and reduce the complication and mortality, and improve quality of life of patients.

关 键 词：关节置换 深静脉血栓 护理 

分 类 号：R473.6[医药卫生—护理学] R687.4[医药卫生—临床医学]