腰椎术后患者应用间歇充气加压装置的依从性现状及原因分析  

Compliance status and reason analysis of patients with intermittent pneumatic compression device after lumbar surgery

作　　者：王丽莉 李高洋[1] 佟冰渡[1] 陈亚萍[1] WANG Lili;LI Gaoyang;TONG Bingdu;CHEN Yaping(Department of Orthopaedics,Peking Union Medical College Hospital,Beijing 100730,P.R.China)

机构地区：[1]北京协和医院骨科,北京100730

出　　处：《华西医学》2023年第10期1480-1484,共5页West China Medical Journal

基　　金：北京协和医院中央高水平医院临床科研专项资金(2022-PUMCH-B-130);北京协和医院护理部科研课题(XHHLKY202008)。

摘　　要：目的调查腰椎术后患者应用间歇充气加压装置(intermittent pneumatic compression device,IPCD)的依从性现状,分析影响依从性的原因及影响因素。方法采用连续入组方法选取2022年12月—2023年6月在北京协和医院骨科行腰椎开放融合手术患者。收集患者一般资料及其使用IPCD的依从性情况,并分析影响依从性的原因。结果共纳入患者46例。患者依从性优的整体比例较低,依从性较差。在术后第1天和第2天的白天依从性相对较好(依从性优占比为39%~52%);夜间的依从性明显低于白天(依从性优占比21%~26%);术后第3天之后的依从性明显下降。共计观察患者460例次,收集患者没有应用IPCD的原因195条,其原因主要为装置导致身体不适、床旁活动时不方便以及患者觉得意义不大。女性患者的依从性好于男性(P<0.05);文化程度为小学及以下患者的依从性最高,高中及以上患者的依从性最低(P<0.05);不同年龄患者间的依从性无统计学差异(P>0.05)。结论腰椎术后患者应用IPCD依从性整体较差,是临床亟需解决的问题,患者对装置的适应性以及认知水平是影响依从性的主要因素。临床护理工作中,对男性以及文化程度较高的患者应加强管理。Objective To investigate the compliance status of intermittent pneumatic compression device(IPCD)in patients after lumbar surgery,and to analyze the reasons and influencing factors affecting compliance.Methods The continuous enrollment method was used to select patients who underwent posterior decompression for lumbar degenerative diseases in the orthopedic department of Peking Union Medical College Hospital between December 2022 and June 2023.The general information of patients and their compliance with IPCD were collected,and the reasons that affected compliance were analyzed.Results A total of 46 patients were included.The overall proportion of patients with good compliance was relatively low,and their compliance was poor.On the first and second day after surgery,the daytime compliance was relatively good(the proportion range of excellent compliance was 39%-52%);the compliance at night was significantly lower than that during the daytime(the proportion range of excellent compliance was 21%-26%);after 3 days of surgery,the patients’compliance significantly decreased.A total of 460 time periods were observed and 195 reasons for not using IPCD were collected.The main reasons were physical discomfort caused by the device,inconvenience during bedside activities,and little significance to the patient.The compliance of female patients was better than that of males(P<0.05).Patients with education level of primary school and below had the highest compliance,while patients with high school and above had the lowest compliance(P<0.05).There was no statistically significant difference in compliance among patients of different age groups(P>0.05).Conclusions The overall compliance of patients with IPCD after lumbar surgery is poor,which is an urgent clinical problem,and the adaptability and cognitive level of patients to the device are the main factors affecting compliance.In clinical nursing work,men and patients with higher education level should be strengthened.

关 键 词：腰椎手术 静脉血栓栓塞症 间歇充气加压装置 依从性 

分 类 号：R473.6[医药卫生—护理学]