中老年髋膝关节置换术后患者下肢深静脉血栓的综合干预策略研究  

The effectiveness of combined measures on prevention of deep venous thrombosis in mid-elderly patients undergoing total joint replacement

作　　者：李春会[1] 李惠玲[2] 邹叶芳[2] 景秀琛[2] 胡化刚[1] 陈利勤[2] 

机构地区：[1]苏州大学护理学院,苏州市215006 [2]苏州大学附属第一医院

出　　处：《中华护理杂志》2015年第5期532-536,共5页Chinese Journal of Nursing

基　　金：苏州市科技计划项目资助(SYS201313)

摘　　要：目的 构建预防髋、膝关节置换术后下肢深静脉血栓（deep vein thrombosis，DVT）的综合干预方案，实施并评价该方案在预防中老年髋、膝关节置换术后DVT的干预效果。方法 将90例患者随机分为对照组（45例）和干预组（45例）。对照组接受预防DVT的常规护理；干预组患者给予基于DVT预防指南的综合干预策略，主要包括以健康信念模式为指导的健康教育、早期功能锻炼、梯度压力弹力袜或间歇充气加压装置、药物预防4项。结果 术后5～7d，干预组DVT疾病相关知识及健康信念水平的评分均优于对照组，差异均有统计学意义（P〈0．05）。干预组血浆D．二聚体水平明显低于对照组（P〈0．05）。干预组出现1例血流淤滞，对照组出现2例DVT、6例血流淤滞，干预组效果优于对照组，差异具有统计学意义（P〈0．05）。结论 基于DVT预防指南的综合干预策略能够减轻关节置换患者术后DVT的相关症状．对降低DVT发生风险有效。Objective To evaluate the effectiveness of combined measures on prevention of deep venous throm- bosis（DVT） in patients undergoing total hip arthroplasty（THA） and total knee arthroplasty（TKA）. Methods Ninety patients undergoing THA or TKA were randomly divided into two groups,45 cases in each group. The patients in the control group received routine nursing care. In addition,the patients in the experimental group received com- bined measures,including health education based on health belief model,early exercises after total joint replacement, graduated compression stockings or intermittent pneumatic compression and pharmacological prophylaxis. Results From the 5th to 7th day after surgery,the scores of DVT related knowledge and health beliefs in the experimental group were significantly higher than those in the control group（P〈0.05）. The level of D-dimer in the experimental group was lower than that in the control group（P〈0.05）. One patient appeared blood stasis in the experimental group, while two cases of DVT and six cases of blood stasis were found in the control group（P〈0.05）. Conclusion Combined measures can decrease symptoms of DVT and prevent DVT in patients undergoing total joint replacement.

关 键 词：静脉血栓形成 健康信念模式 综合预防 关节成形术 

分 类 号：R473.6[医药卫生—护理学]