医护一体化模式预防老年髋部骨折患者围手术期静脉血栓栓塞症的效果评价  

Effects of doctor-nursing integration mode on the prevention of perioperative venous thromboembolism in geriatric patients with hip fracture

作　　者：金占萍[1] 朱迎春[1] 谢浩芬[2] 徐梅 陈慧慧 杨盼盼 刘飞舞[1] 陆云飞 Jin Zhanping;Zhu Yingchun;Xie Haofen;Xu Mei;Chen Huihui;Yang Panpan;Liu Feiwu;Lu Yunfei(Department of Orthopaedics, Ningbo First Hospital, Zhejiang Province, Ningbo 315010, China;Nursing Department, Ningbo First Hospital, Zhejiang Province, Ningbo 315010, China;Statistics Office, Ningbo First Hospital, Ningbo 315010, China)

机构地区：[1]浙江省宁波市第一医院骨科,315010 [2]浙江省宁波市第一医院护理部,315010 [3]浙江省宁波市第一医院统计室,315010

出　　处：《中华现代护理杂志》2019年第18期2319-2323,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨医护一体化模式预防老年髋部骨折患者围手术期静脉血栓栓塞症(venous thromboembolism,VTE)的临床疗效。方法以2018年1-6月宁波市第一医院骨科收治的120例老年髋部骨折患者为研究对象,根据入院时间分为对照组(n=58)及试验组(n=62)。对照组采用常规护理模式,试验组采取医护一体化护理模式。比较两组患者VTE疾病相关知识评分、患侧肢体肿胀程度、血浆D-二聚体水平、下肢DVT以及肺栓塞发生率等指标。结果术后1周试验组患者VTE相关知识评分高于对照组,差异具有统计学意义(P<0.05);术后第1天、术后第1周试验组患侧肢体髌上10 cm肿胀程度低于对照组,术后1周、术后2周试验组患者血浆D-二聚体水平低于对照组,差异均有统计学意义(P<0.05);对照组患者围手术期下肢DVT发生率为11.4%,低于试验组的25.8%,差异具有统计学意义(P<0.05)。结论医护一体化护理模式可提高老年髋部骨折患者血栓防治依从性,减轻患者围手术期VTE相关症状,降低围手术期下肢DVT发生率。Objective To evaluate the clinical effectiveness of doctor-nursing integration mode on the prevention of venous thromboembolism (VTE) in geriatric patients with hip fracture. Methods From January to June of 2018, a total of 120 elderly patients with hip fracture admitted to the orthopaedic department of Ningbo First Hospital were selected in this study. According to the time of admission, they were divided into the control group (n=58) and the observation group (n=62). The conventional nursing mode was adopted in the control group and doctor-nursing integration nursing mode was adopted in the observation group. The two groups were compared in terms of the scores of VTE related knowledge, swelling degree of the affected limbs, the plasma D-Dimer level and the incidence of DVT on the lower limbs as well as the pulmonary thrombus. Results One week after surgery, the patients in the observation group achieved higher score in the VTE related knowledge than the control group with statistical significance (P<0.05);one day and one week after surgery, the observation group was lower than the control group in the swelling degree of the 10cm above the hip of the affected limb;one week and two weeks after surgery, the observation group was lower than the control group in the plasma D-Dimer level, both with statistical significance (P<0.05);the control group's incidence of perioperative DVT on the lower limbs was 11.4%, lower than the 25.8% in the observation group with statistical significance (P<0.05). Conclusions Doctor-nursing integration nursing model can help to improve the compliance with the thrombosis prevention of the elderly patients with hip fracture, relieve the symptoms related to perioperative VTE and reduce the incidence of DVT on the lower limbs.

关 键 词：老年人 髋部骨折 围手术期护理 静脉血栓栓塞症 深静脉血栓 医护一体化 

分 类 号：R473.6[医药卫生—护理学]