复合护理干预预防骨科术后深静脉血栓的临床研究  

Clinical study on combined nursing intervention in prevention of deep vein thrombosis after orthope-dics surgery

作　　者：李莉[1] 张丽天[1] 申雅文[1] 丁然 程芳芳[1] 陈婷婷[1] 潘琳琳[1] 谢志伟[1] 杨艳[1] 臧苑彤 Li Li;Zhang Litian;Shen Yawen;Ding Ran;Cheng Fangfang;Chen Tingting;Pan Linlin;Xie Zhiwei;Yang Yan(Department of thoracic,Lumbar and spinal surgery,Hohhot 010030,China)

机构地区：[1]内蒙古医科大学第二附属医院脊柱外科,呼和浩特010030

出　　处：《中华老年骨科与康复电子杂志》2022年第3期177-181,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：内蒙古卫生厅资助项目(201702101);内蒙古医科大学科技百万联合项目(YLD2022KJBW(LH)026)。

摘　　要：目的探讨复合护理干预模式改善骨科术后深静脉血栓(DVT)的预防效果,为骨科病房降低血栓发生率提供实践指导。方法前瞻性收集2016年5月至2018年2月内蒙古医科大学第二附属医院骨科收治的骨科大手术术后患者166例,其中试验组性别人数(男/女,35/48),对照组性别人数(男/女,36/47);试验组和对照组年龄均为(57±6)岁,以随机数字表法随机分为试验组和对照组各83例。对照组患者接受一般围手术期护理,试验组按照复合护理干预的思维和方法,制定针对性DVT预防护理流程,观察两组患者术后主要血液指标(血浆D-二聚体、血小板)变化、DVT发生率及患者满意度。结果与对照组比较,试验组术后DVT近端发生率(2.41%),远端发生率(4.82%)更低(X^(2)=26.231,P<0.05),患者的护理满意度(97.2%)评价较高(X^(2)=11.093,P<0.05)。同时,试验组术后24 hD-二聚体水平(6.4±0.5)较对照组低、血小板计数(142±26)较对照组高(t=2.061,t=11.582,P<0.05)。结论复合护理干预用于骨科围手术期临床实境,可以有效降低血栓发生率,不增加出血风险,对于骨科术后深静脉血栓的合理防控具有重要临床意义。Objective To explore the effect of combined nursing intervention on the prevention of deep vein thrombosis(DVT)after orthopedics surgery and provide guidance for the orthopedics department to reduce the incidence of thrombosis.Methods A total of 166 patients undergoing major orthopaedic surgery in the Department of Orthopaedics,the Second Affiliated Hospital of Inner Mongolia Medical University from May 2016 to February 2018 were randomly divided into the experimental group and the control group.The pa-tients in the control group underwent general perioperative nursing.The experimental group developed a target-ed DVT preventive nursing process according to the thinking and methods of"composite nursing interven-tion".The main blood indexes(plasma D-dimer,platelet)of the two groups were observed.Changes,DVT inci-dence,and patient satisfaction.Results Compared with control group,experimental group a lower incidence of postoperative DVT(X^(2)=26.231,P<0.05),the patient's nursing satisfaction rate higher(X^(2)=11.093,P<0.05).Meanwhile,the d-dimer level of the experimental group was lower than that of the control group 24 hours after surgery,and the platelet count was higher than that of the control group(t=2.061,t=11.582,P<0.05).Conclu-sions The composite nursing intervention is used in the perioperative clinical practice of orthopedics,which can effectively reduce the incidence of thrombosis without increasing the risk of bleeding.It has important clinical significance for the reasonable prevention and control of deep venous thrombosis DVTafter orthopedic surgery.

关 键 词：静脉血栓形成 骨科 复合护理干预 

分 类 号：R47[医药卫生—护理学]