集束化干预在预防腹腔镜下肠道疾病手术患者深静脉血栓形成中的作用  

Role of cluster intervention in the prevention of deep vein thrombosis in patients undergoing laparoscopic surgery for intestinal diseases

作　　者：廖春艳[1] 郑见宝[1] 樊慧[1] 张红梅[1] 乔莉娜[1] LIAO Chunyan;ZHENG Jianbao;FAN Hui;ZHANG Hongmei;QIAO Li′na(Department of General Surgery,the First Affiliated Hospital of Xi′an Jiaotong University,Shaanxi Province,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院普通外科

出　　处：《中国医药导报》2019年第25期175-178,共4页China Medical Herald

基　　金：陕西省社会发展科技攻关项目(2016SF-141)

摘　　要：目的评价集束化干预在预防腹腔镜下肠道疾病手术患者深静脉血栓形成中的作用。方法将2017年4月~2018年5月在西安交通大学第一附属医院普通外科接受腹腔镜手术治疗的267例肠道疾病患者,采用随机数字表法分为两组,观察组(133例)予以集束化干预护理,对照组(134例)予以普通外科常规护理,比较两组患者凝血功能、术后首次排气时间、住院时间、住院费用、并发症发生情况及护理工作质量评价满意度。结果术后5 d,两组的纤维蛋白原和D-二聚体水平均较术前升高,但观察组低于对照组,差异均有统计学意义(均P<0.05)。观察组的术后首次排气时间、住院时间均明显短于对照组,住院费用少于对照组,差异均有统计学意义(P<0.05或P<0.01)。观察组的术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。出院时,观察组的护理工作质量评价总满意度高于对照组,差异有统计学意义(P<0.05)。结论集束化干预能显著改善腹腔镜下肠道疾病手术患者的凝血状态,有效降低深静脉血栓的发生率,并可明显缩短患者的住院时间,减少医疗费用,有利于改善患者的生活质量,值得临床护理小组参考和借鉴选用。Objective To evaluate the role of cluster intervention in the prevention of deep vein thrombosis in patients undergoing laparoscopic surgery for intestinal diseases. Methods From April 2017 to May 2018, 267 patients with intestinal diseases underwent laparoscopic surgery at Department of General Surgery, the First Affiliated Hospital of Xi′an Jiaotong University were divided into two groups by random number table method. Observation group (133 cases) was treated with cluster intervention nursing, and control group (134 cases) was treated with routine nursing in general surgery. The coagulation function, first exhaust time after operation, hospitalization time, hospitalization expenses, complications and satisfaction of nursing quality evaluation were compared between two groups. Results After operation of 5 days, the levels of fibrinogen and D-dimer in both groups were higher than those before operation, but those in observation group were lower than those in control group, with statistical significance (all P<0.05). The first exhaust time after operation and hospitalization time of observation group were significantly shorter than those of control group, and the hospitalization expenses of observation group were less than those of control group, the differences were statistically significant (P<0.05 or P<0.01). The incidence of postoperative complication in observation group was lower than that in control group (P<0.05). When discharged from hospital, total satisfaction of nursing quality evaluation in observation group was higher than that in control group, and the difference was statistically significant (P<0.05). Conclusion Cluster intervention can significantly improve the coagulation status of patients undergoing laparoscopic surgery of intestinal disease, effectively reduce the incidence of deep vein thrombosis, significantly shorten hospitalization time and reduce medical expenses of patients. It is conducive to improving the quality of life of patients and is worthy of reference by the clinical nursing

关 键 词：集束化干预 普通外科 腹腔镜手术 深静脉血栓 

分 类 号：R473.6[医药卫生—护理学]