神经内科ICU老年患者下肢DVT的临床特点与护理  

Clinical characteristics and nursing of lower extremity deep vein thrombosis in elderly patients in Intensive Care Unit of Neurology Department

作　　者：刘芳[1] 龚立超[1] 杨亭 付雯雯 Liu Fang;Gong Lichao;Yang Ting;Fu Wenwen(Neurology Intensive Care Unit, Xuanwu Hospital Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院神经内科ICU,北京100053

出　　处：《中华现代护理杂志》2019年第25期3195-3199,共5页Chinese Journal of Modern Nursing

摘　　要：目的分析神经内科ICU老年患者下肢DVT的临床特点,为早期实施预防策略提供依据。方法收集2017年3月—2018年10月某医院神经内科ICU收治229例患者为研究对象,并根据年龄分为老年组(年龄≥60岁)和非老年组(年龄<60岁)。自行设计调查表,收集患者的一般资料、下肢DVT的相关因素以及老年人常见既往高血压、糖尿病史等资料,应用SPSS 22.0软件进行数据分析。结果229例患者中,确诊为下肢DVT患者97例,发生率为42.4%,其中老年组发生下肢DVT为62例,发生率为57.4%,非老年组为35例,发生率为28.9%,两组比较差异有统计学意义(P<0.05);两组患者在发生血栓时纤维蛋白原值、既往有无高血压、糖尿病以及心脏病、是否使用激素药方面比较差异均有统计学意义(P<0.05)。两组患者发生下肢DVT的血管位置比较差异无统计学意义(P>0.05),均以肌间静脉血栓为主。结论缺血性脑血管病、高水平纤维蛋白原同时伴有高血压、糖尿病以及心脏病是神经内科ICU老年患者下肢DVT形成的主要因素,减少激素应用是预防下肢DVT的保护性因素。神经内科ICU需要早期关注老年人的下肢DVT的发生,尤其以肌间静脉血栓为主,早期启动预防干预的防控策略,降低神经内科ICU老年患者下肢DVT的发生率。Objective To analyze the clinical characteristics of lower extremity deep venous thrombosis (DVT) in elderly patients in Intensive Care Unit (ICU) of Neurology Department, and to provide evidence for early implementation of preventive strategies. Methods Totally 229 patients who were admitted to the ICU of Neurology Department in a hospital from March 2017 to October 2018 were collected as the participants of the study and divided into the elderly group (age≥60 years) and non-elderly group (age<60 years) according to their ages. Self-designed questionnaire was used to collect the patients' general information, relevant factors of the lower extremity DVT, and information of commonly seen problems in elderly population such as history of hypertension and diabetes. SPSS 22.0 was used for data analysis. Results Among the 229 patients, 97 were diagnosed as lower extremity DVT, the incidence was 42.4%. Among them, the number of lower extremity DVT in the elderly group was 62, and the incidence was 57.4%, while the number in the non-elderly group was 35, and the incidence was 28.9%, and there was statistically significant difference between the two groups (P<0.05). There were statistically significant difference between the two groups in terms of fibrinogen value during thrombosis, hypertension history, diabetes, heart disease and hormone drug use, etc (P<0.05). There was no statistical difference in the vascular location of DVT in lower extremities between the two groups (P>0.05), and the main type of DVT was intramuscular venous thrombosis. Conclusions Ischemic cerebrovascular disease, high level fibrinogen accompanied by hypertension, diabetes mellitus and heart disease are the main factors of DVT formation in the lower extremity of elderly patients in ICU of Neurology Department. Reducing hormone use is the protective factor of DVT prevention in lower extremities. Neurological ICU needs to pay early attention to the occurrence of DVT in the lower extremities of the elderly, especially the intramuscular venous thro

关 键 词：静脉血栓形成 下肢 神经内科 重症监护病房 

分 类 号：R473.74[医药卫生—护理学]