围手术期强化护理降低肺癌患者术后血栓栓塞事件发生的效果

目的分析围手术期强化护理降低肺癌患者术后血栓栓塞事件发生的效果。方法 84例肺癌患者随机分为实践组(n=42)和对照组(n=42),对照组给予常规护理,实践组进行围手术期强化护理。检测两组患者护理前后血液纤溶指标及血小板参数变化情况,统计两组术后1个月内血栓栓塞事件及其他并发症发生情况,并于护理前后评估患者的肺功能。结果两组护理前组织型纤溶酶原激活物(t PA)活性、D二聚体(D-D)浓度及血小板计数(PLT)比较无统计学意义(P0.05),护理后t PA、D-D、PLT均显著降低(P0.05),但实践组t PA、D-D、PLT显著低于对照组(P0.05)。术后1个月内实践组血栓栓塞事件DVT、PE发生率均低于对照组(P0.05)。两组护理前肺功能比较无统计学意义(P0.05),护理后第一秒呼吸气体的容积(FEV1)、用力呼吸的肺活量(FVC)均显著升高(P0.05),但实践组FEV1、FVC显著高于对照组(P0.05)。结论有效的围手术期强化护理措施可有效降低肺癌患者术后血栓栓塞事件发生率,并有助于术后肺功能的改善。

The Effects of Perioperative Intensive Nursing in Reducing the Incidence of Postoperative Thromboembolic Events in Patients with Lung Cancer

Objective To analyze the effects of perioperative intensive nursing in reducing the incidence of postoperative thromboembolic events in patients with lung cancer .Methods 84 patients with lung cancer were randomly divided into the practice group (n=42)and the control group(n=42).The control group were given routine nursing while the practice group were given perioperative intensive nursing .The changes of blood fibrinolytic indexes and platelet parameters in the two groups before and after nursing were detected ,and the incidence of thromboembolic events and other complications in the two groups within 1 month after operation was statistically analyzed .The pulmonary function of patients was evaluated before and after nursing.Results Before nursing,the tissue type plasminogen activator (tPA)activity,D-dimer(D-D)levels and platelet count ( PLT) showed no significant differences between the two groups before nursing ( P>0.05 ) . After nursing , tPA, D-D and PLT were significantly decreased , and those in the practice group were significantly lower than the control group ( P<0.05 ) .The incidence rates of thromboembolic events ( DVT, PE) in the practice group within 1 month after operation were also significantly lower than that in the control group ( P <0.05 ) .The pulmonary function showed no significant difference between the two groups before nursing ( P>0.05 ) .After nursing ,the forced expiratory volume in 1 second ( FEV1 ) and forced expiratory vital capacity(FVC)were significantly increased,and FEV1,FVC of the practice group were significantly higher than those of the control group ( P <0.05 ) .Conclusion Effective perioperative nursing intervention can effectively reduce the incidence of postoperative thromboembolic events in patients with lung cancer ,and it is helpful to improve the postoperative pulmonary function .