基于风险评估的个体化预防护理联合低分子肝素对子痫前期孕妇剖宫产术后下肢深静脉血栓发生的影响  

Effect of Individualized Preventive Nursing Based on Risk Assessment Combined with Low Molecular Weight Heparin on the Occurrence of Lower Deep Vein Thrombosis in Pregnant Women with Preeclampsia after Cesarean Section

作　　者：彭银琴 陈婵 黄节红 PENG Yinqin;CHEN Chan;HUANG Jiehong(Department of Obstetrics and Gynecology,Yingtan City People's Hospital,Yingtan 335000,China;不详)

机构地区：[1]鹰潭市人民医院妇产科,江西鹰潭335000

出　　处：《中国医学创新》2024年第28期100-104,共5页Medical Innovation of China

摘　　要：目的:探究基于风险评估的个体化预防护理联合低分子肝素对子痫前期孕妇剖宫产术后下肢深静脉血栓(DVT)发生的影响。方法:选取2022年1月—2023年6月于鹰潭市人民医院妇产科行剖宫产术的子痫前期孕妇64例,以随机数字表法分为对照组(n=32,给予常规预防护理与低分子肝素)及观察组(n=32,在对照组基础上进行基于风险评估的个体化预防护理)。对比两组DVT发生情况、下肢周径及凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及血小板计数(PLT)]。结果:与对照组(25.00%)对比,观察组DVT发生率(3.13%)显著低(P<0.05);术后5 d及出院时,观察组下肢周径[(39.74±3.27)、(38.79±3.38)cm]均小于对照组[(41.75±4.04)、(40.68±3.54)cm](P<0.05);术后7 d,两组APTT、PT均延长,PLT均升高,且与对照组[(32.28±2.59)s、(10.63±1.64)s、(244.73±19.47)×10^(9)/L]对比,观察组APTT、PT[(34.37±2.71)、(11.57±1.16)s]均显著长,PLT[(253.95±13.81)×10^(9)/L]显著高(P<0.05)。结论:基于风险评估的个体化预防护理联合低分子肝素用于子痫前期孕妇,可有效降低剖宫产术后下肢DVT发生风险,减轻下肢肿胀程度,改善凝血功能。Objective:To explore the effect of individualized preventive nursing based on risk assessment combined with Low Molecular Weight Heparin on the occurrence of lower deep vein thrombosis(DVT)in pregnant women with preeclampsia after cesarean section.Method:A total of 64 pregnant women with preeclampsia who underwent cesarean section in Department of Obstetrics and Gynecology,Yingtan City People's Hospital from January 2022 to June 2023 were selected and divided into control group(n=32,given routine preventive nursing combined with Low Molecular Weight Heparin)and observation group(n=32,individualized preventive nursing based on risk assessment was performed on the basis of control group)by random number table method.The occurrence of lower DVT,lower limb circumference and coagulation function indicators[activated partial thromboplastin(APTT),prothrombin time(PT)and platelet count(PLT)]were compared between two groups.Result:Compared with the control group(25.00%),the incidence of lower DVT in observation group(3.13%)was significantly lower(P<0.05).5 days after operation and at discharge,the lower limb circumference of observation group[(39.74±3.27),(38.79±3.38)cm]were smaller than those of control group[(41.75±4.04),(40.68±3.54)cm](P<0.05).7 days after operation,the levels of APTT and PT were prolonged and levels of PLT were increased in both groups,and compared with the levels of the control group[(32.28±2.59)s,(10.63±1.64)s,(244.73±19.47)×10^(9)/L],APTT and PT[(34.37±2.71)and(11.57±1.16)s]in the observation group were significantly longer,and PLT[(253.95±13.81)×10^(9)/L]was significantly higher(P<0.05).Conclusion:Individualized preventive nursing based on risk assessment combined with low molecular weight heparin for pregnant women with preeclampsia can effectively reduce the risk of lower DVT after cesarean section,reduce the degree of lower limb circumference,and improve coagulation function.

关 键 词：风险评估 个体化预防护理 低分子肝素 子痫前期 剖宫产 下肢深静脉血栓 

分 类 号：R473.71[医药卫生—护理学]