缺血性脑卒中患者静脉血栓栓塞症非药物预防与管理的循证实践  

Evidence-based practice for non-pharmacological prevention and management of venous thromboembolism in ischemic stroke patients

作　　者：张艳红 宦迎春[1] 朱丽群[2] 秦洁 Zhang Yanhong;Huan Yingchun;Zhu Liqun;Qin Jie(Department of Neurology,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China;Department of Nursing,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院神经内科,镇江212001 [2]江苏大学附属医院护理部,镇江212001

出　　处：《中华现代护理杂志》2025年第5期628-633,共6页Chinese Journal of Modern Nursing

基　　金：江苏大学临床医学专项基金(JDLCHL202203)。

摘　　要：目的探讨基于最佳证据的缺血性脑卒中患者静脉血栓栓塞症(VTE)非药物预防与管理方法并评价其应用效果。方法本研究在证据获取的基础上,以渥太华研究应用模式为指导,通过临床审查剖析证据应用的障碍和促进因素,实施干预策略和效果评价。采用便利抽样法,在证据应用前后选择江苏大学附属医院神经内科住院患者和护士为研究对象。基线审查时间为2023年3月1日—5月31日,审查对象为此期间在神经内科住院治疗的100例患者以及工作的32名护士,证据应用审查时间为2023年12月1日—2024年2月29日,审查对象为此期间在神经内科住院治疗的100例患者以及工作的32名护士。比较证据应用前后护士及患者的VTE非药物预防知识水平、审查指标执行率以及患者VTE发生率。结果证据应用后,大部分证据执行率高于证据应用前,差异有统计学意义(P<0.05)。缺血性脑卒中患者、护士的VTE非药物预防知识得分高于证据应用前,差异有统计学意义(P<0.05);缺血性脑卒中患者的VTE发生率低于证据应用前,差异有统计学意义(P<0.05)。结论以渥太华研究应用模式为指导的缺血性脑卒中患者VTE非药物预防与管理的循证实践能够有效提升护士的VTE非药物预防与管理的循证依从性,同时增强患者VTE非药物预防知识,从而降低VTE发生率。ObjectiveTo explore non-pharmacological prevention and management methods for venous thromboembolism(VTE)in ischemic stroke(IS)patients based on the best evidence and evaluate the effectiveness of their application.MethodsBased on evidence acquisition,this study was guided by the Ottawa model of research use to dissect the barriers and facilitators of evidence application through clinical review,and to implement intervention strategies and effect evaluation.Convenience sampling method was used to select inpatients and nurses in the Department of Neurology of Affiliated Hospital of Jiangsu University before and after evidence application as study subjects.The baseline review period was from March 1 to May 31,2023,and the review subjects were 100 patients hospitalised in the Department of Neurology and 32 nurses working in the Department of Neurology during this period,and the evidence application review period was from December 1,2023 to February 29,2024,and the review subjects were 100 patients hospitalised in the Department of Neurology and 32 nurses working in the Department of Neurology during this period.Nurses and patients knowledge of non-pharmacological prevention of VTE,implementation of the review indicators,and the incidence of VTE in patients were compared before and after the application of the evidence.ResultsAfter evidence application,most of the evidence implementation rates were higher than those before evidence application,and the differences were statistically significant(P<0.05).The VTE non-pharmacological prevention knowledge scores of IS patients and nurses were higher than those before evidence application,and the differences were statistically significant(P<0.05);the VTE incidence rate of IS patients was lower than that before evidence application,and the differences were statistically significant(P<0.05).ConclusionsEvidence-based practice of non-pharmacological prevention and management of VTE in patients with IS,guided by the Ottawa model of research use,can effectively improve nurses evi

关 键 词：卒中 静脉血栓 缺血性脑卒中 非药物 预防 循证护理 

分 类 号：R47[医药卫生—护理学]