复合护理干预预防骨科术后深静脉血栓的临床研究

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（χ²=26.231,P<0.05）,患者的护理满意度（97.2%）评价较高（χ²=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。

Clinical study on combined nursing intervention in prevention of deep vein thrombosis after orthopedics surgery

ObjectiveTo 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. MethodsA 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 patients in the control group underwent general perioperative nursing. The experimental group developed a targeted DVT preventive nursing process according to the thinking and methods of "composite nursing intervention". The main blood indexes (plasma D-dimer, platelet) of the two groups were observed. Changes, DVT incidence, and patient satisfaction. ResultsCompared with control group, experimental group a lower incidence of postoperative DVT (χ²=26.231, P<0.05), the patient's nursing satisfaction rate higher (χ²=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). ConclusionsThe 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 DVT after orthopedic surgery.