预见性护理在腰椎管狭窄术后下肢深静脉血栓形成中的预防作用  

The effects of predictive nursing in preventing the incidence of deep venous thrombosis of lower extremity after lumbar stenosis surgery

作　　者：马清华[1] 苏丹[1] 王瑞玲[1] MA Qinghua;SU Dan;WANG Ruiling(Department of Spinal Column Surgery,The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院脊柱骨科,石家庄市050051

出　　处：《河北医药》2020年第20期3184-3186,3190,共4页Hebei Medical Journal

摘　　要：目的分析预见性护理对腰椎管狭窄减压内固定术后下肢深静脉血栓(DVT)形成的预防作用。方法回顾性分析2017年10月至2018年9月接受手术治疗的116例腰椎管狭窄症患者的临床资料,术后根据护理方法将其分成2组,对照组58例,采用常规护理;观察组58例,根据患者血栓风险等级采用预见性护理。记录并比较2组患者手术前后D-二聚体水平及下肢血流速度变化情况,观察患者DVT及肺栓塞发生情况。结果术后3 d及术后1周时,观察组下肢血流速度均高于对照组,差异有统计学意义(P<0.05)。术后2组D-二聚体水平均较术前有显著升高(P<0.05),但观察组D-二聚体明显低于对照组(P<0.05);且维持至术后1周时,观察组D-二聚体水平仍显著低于对照组(P<0.05)。观察组DVT发生率5.2%(3/58),对照组发生率15.5%(9/58),组间比较差异有统计学意义(P<0.05)。结论腰椎管狭窄术后,根据患者血栓危险等级采用物理预防、机械预防、床尾抬高及药物预防等预见性护理措施,能够快速促进下肢血流速度的改善,显著降低下肢深静脉血栓的发生。Objective To investigate the effects of predictive nursing in preventing the incidence of deep venous thrombosis(DVT)of lower extremity after lumbar stenosis surgery.Methods The clinical data about 116 patients with lumbar spinal stenosis who were treated by surgery in our hospital from October 2017 to September 2018 were respectively analyzed,who were divided into two groups according to different nursing methods.The 58 patients in control group were treated by routine nursing,however,the other 58 patients in observation group were treated by predictive nursing based on the patient’s thrombus risk level.The changes of D-dimer levels,blood flow velocity of lower limbs were observed and compared between the two groups.Moreover the incidence rate of DVT and pulmonary embolism was observed.Results The blood flow velocity at 3d and 1w after operation in observation group was significantly higher than that in control group(P<0.05).After operation the D-dimer levels in both groups were significantly increased,as compared with those before operation(P<0.05),moreover,which in observation group at 1w after operation were significantly lower than those in control group(P<0.05).In addition the incidence rate of DVT in observation group was 5.2%(3/58),which in control group was 15.5%(9/58),there was a significant difference between the two groups(P<0.05).Conclusion The predictive nursing after lumbar stenosis surgery can effectively prevent the incidence of deep venous thrombosis by physical,drug,posture and other preventive nursing measures,which can quickly improve the blood flow velocity and significantly reduce the incidence of deep venous thrombosis.

关 键 词：预见性护理 脊柱术后 下肢深静脉血栓 预防作用 

分 类 号：R473.6[医药卫生—护理学]