早期康复护理对高血压脑出血患者术后凝血相关并发症的预防效果

目的 研究早期康复护理对高血压脑出血患者术后凝血相关并发症的预防效果.方法 抽选2013年3月至2016年4月本院收治的高血压脑出血患者99例,随机数字表法分为观察组(n=52)和对照组(n=47),所有患者均按常规高血压脑出血病给予对症治疗,包括微创血肿清除术、抗血小板聚集、抗感染、控制血压等,对照组配合常规护理,观察组在此基础上给予早期康复护理.检测护理前后两组患者纤维蛋白原(FBG)、血小板计数(PLT)、抗凝血酶-Ⅲ(AT-Ⅲ)、血浆D-D二聚体(D-D)水平和血压变化;观察两组患者术后并发症发生情况.结果 两组患者护理前凝血功能相关指标及血压水平对比差异无统计意义(P＞0.05);护理后观察组与对照组各指标水平分别如下,FBG(3.20±0.35)g/L比(4.67±0.58) g/L、D-D (0.73±0.11) mg/L比(0.78 ±0.17) mg/L、收缩压(122.96±11.73) mmHg比(140.28±10.49) mmHg、舒张压(84.19±9.43) mmHg比(95.37±10.30)mmHg,以上指标观察组均低于对照组;PLT(183.54±41.61)×109/L比(176.33±44.08)×109/L、AT-Ⅲ(88.42±11.80)％比(80.36±12.90)％,以上指标观察组均高于对照组,差异均有统计学意义(均P＜0.05).观察组术后凝血相关并发症发生率7.69％与对照组31.91％比较显著较低(P＜0.05).结论 早期康复护理能通过对高血压脑出血患者术后凝血指标进行改善,达到阻止或降低术后血栓形成风险的目的,并通过加强血压监测、及早监督患者进行康复训练等手段,还能避免术后血压过高,降低再出血、下肢静脉血栓等不良并发症发生率.

Preventive effect of early rehabilitation nursing on postoperative blood coagulation related complications in patients with hypertensive cerebral hemorrhage

Objective To study the preventive effect of early rehabilitation nursing on postoperative blood coagulation related complications in patients with hypertensive cerebral hemorrhage.Methods 98 patients with hypertensive cerebral hemorrhage treated in our hospital during March 2013 and April 2016 were selected and divided into observation group (n=52) and control group (n=47) by the random number table method.All patients were given routine symptomatic treatment for hypertensive cerebral hemorrhage,including minimally invasive evacuation of hematoma,anti-platelet aggregation,anti-infection,and control of blood pressure,etc..The control group was given routine nursing,and the observation group was given early rehabilitation nursing on the basis.Changes of levels of fibrinogen (FBG),platelet count (PLT),antithrombin Ⅲ (AT-Ⅲ),plasma D-Dimer (D-D),and blood pressure in the two groups were detected before and after nursing,the incidence of postoperative complications in the two groups were observed.Results There were no statistically significant differences between the two groups in related indexes of blood coagulation function and blood pressure before nursing (P＞0.05).After nursing,FBG,D-D,systolic pressure,and diastolic blood pressure in the observation group were lower than those in the control group (3.20±0.35) g/L vs (4.67±0.58) g/L,(0.73±0.11) mg/L vs (0.88±0.17) mg/L,(122.96± 11.73)mmHg vs (140.28±10.49) mmHg,(84.19±9.43) mmHg vs (95.37±10.30) mmHg],while PLT and AT-Ⅲ were higher than those in the control group (183.54±41.61)×109/L vs (176.33±44.08)×109/L,(88.42±11.80)％ vs (80.36±12.90)％] (P＜ 0.05).The incidence of coagulation related complications in the observation group was significantly lower than that in the control group (7.69％ vs 31.91％) (P＜0.05).Conclusion Early rehabilitation nursing can improve the coagulation indexes in patients with hypertensive cerebral hemorrhage after operation to prevent or reduce the risk of postoperative thrombosis,and it also can avoid high blood pressure after operation,reduce the incidence of rebleeding,venous thrombosis and other adverse complications by strengthening the monitoring of blood pressure and early rehabilitation training.