不同运动干预方式预防老年腹部手术患者术后下肢深静脉血栓的效果  

Effects of different exercise interventions on prevention of DVT among elderly patients undergoing abdominal operation

作　　者：张莉[1] 张海燕[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)普通外科,210006

出　　处：《中华现代护理杂志》2017年第3期392-395,共4页Chinese Journal of Modern Nursing

摘　　要：目的 探讨不同运动干预方式对老年腹部手术患者术后下肢深静脉血栓发生的影响.方法 采用便利抽样法选取2015年1—12月在南京医科大学附属南京医院普外科择期行腹部手术的老年患者96例,按照随机数字表法分为对照组和观察组,每组48例.对照组于术后去枕平卧6 h,之后每隔2 h翻身1次,观察组在术后2 h即开始给予患者踝关节和肌肉被动运动干预,术后4 h给予翻身和叩背,且要求并鼓励患者多做主动运动.比较两组DVT发生率、术后第3、7天股静脉血流峰速度和平均血流速度.结果 对照组术后发生DVT 16例（33.3%）,观察组6例（12.5%）,观察组DVT发生率低于对照组,差异有统计学意义（χ2=6.257,P〈0.05）;术后第3天和第7天观察组股静脉血流峰速度分别为（48.3±5.8）、（58.8±5.2）ml/min,对照组为（36.1±3.2）、（45.4±3.8）ml/min,观察组高于对照组（t值分别为5.632、6.171;P〈0.05）.术后第3天和第7天观察组股静脉平均血流速度分别为（28.3±3.4）、（34.5±4.6）ml/min,对照组为（20.1±2.2）、（25.7±3.2）ml/min,观察组高于对照组（t值分别为2.421、3.317;P〈0.05）.结论 老年腹部手术患者术后2 h即采取被动运动,术后4 h给予翻身和叩背,鼓励患者多做主动运动可有效改善患者下肢血流速度,预防术后DVT形成.Objective To evaluate the effects of different exercise interventions on the prevention of deep venous thrombosis （DVT） mong elderly patients undergoing abdominal operation.Methods By convenience sampling method,96 elderly patients who underwent abdominal operation were recruited in this study. All the patients were admitted to the general surgery department of Nanjing Hospital Affiliated to Nanjing Medical University from January to December 2015. According to random digits table method,patients were divided evenly into the control group and the observation group. Patients in the control group were asked to keep the horizontal position without pillow for six hours after the operation and turn over every two hours afterwards. On the other hand,patients in the observation group underwent passive exercise intervention on their ankles and muscles two hours after the operation,and they received treatment of turning over and tapping backs four hours after the operation. Besides,they were also encouraged to do more active exercise. The incidence of DVT and the maximum blood flow rate （BFR） as well as the average BFR of femoral veins in three days and seven days after the operation were investigated.Results The number of patients getting DVT in the control group was 16 （33.3%） while that in the observation group was 6 （12.5%）,which means the incidence of DVT in the observation group was lower （χ2=6.257,P〈0.05）. The maximum BFR of femoral veins investigated three days and seven days after operation were （48.3±5.8） and （58.8±5.2） ml/min respectively in the observation group,while the figures were （36.1±3.2） and （45.4±3.8） ml/min respectively in the control group （t=5.632,6.171;P〈0.05）. The average BFR investigated three days and seven days after operation were （28.3±3.4） ml/min and （34.5±4.6） in the observation group and they were （20.1±2.2） and （25.7±3.2） ml/min in the control group （t=2.421,3.317;P〈0.05）.Conclusions Active exercise and passive ex

关 键 词：老年人 静脉血栓形成 血流速度 腹部手术 运动干预 

分 类 号：R473.6[医药卫生—护理学]