护理干预对骨科大手术术后静脉血栓栓塞性疾病的影响

发布时间：2018-09-08 17:52

【摘要】：目的全面记录、分析和比较骨科大手术(人工髋关节置换术、人工膝关节置换术、髋部周围骨折手术)术后行心理干预在预防下肢深静脉血栓及肺栓塞等静脉血栓栓塞性疾病中的作用和效果。方法将2010年1月—2013年1月在骨科住院诊断为相关骨科疾病并给予骨科大手术的患者使用随机数字表随机分为2组,并给予不同的围手术期护理措施:骨科常规护理组(对照组:81例)与护理干预组(实验组:95例)。记录和比较2组患者在围手术期的一般情况指标、肢体周径、深静脉血栓形成等指标。结果所有患者均获得了至少6个月的术后正规随访;护理干预组95例患者中出现深静脉血栓形成的概率为8.42%,对照组81例患者中出现深静脉血栓形成的概率为30.86%,两者相比差异有统计学意义。护理干预组的患者下肢肢体周径[踝上10 cm:(20.37±0.66)cm;髌下10 cm:(35.39±1.70)cm;髌上10 cm:(44.04±3.02)cm]较对照组[踝上10 cm:(23.62±0.99)cm;髌下10 cm:(38.04±1.52)cm;髌上10 cm:(48.76±3.26)cm]明显减小,差异有统计学意义。结论在骨科大手术围手术期给予科学、严谨、正规的护理干预可以对深静脉血栓、肺栓塞等血栓栓塞性疾病起到明显的预防作用,应当进一步的推广和采用。
[Abstract]:Objective to record, analyze and compare major orthopedic surgery (artificial hip arthroplasty, artificial knee arthroplasty). The effect of psychological intervention on the prevention of venous thromboembolic diseases such as deep venous thrombosis and pulmonary embolism. Methods from January 2010 to January 2013, patients who were diagnosed as related orthopedic diseases in orthopedic department and underwent major orthopedic surgery were randomly divided into two groups. Different perioperative nursing measures were given: routine orthopedic nursing group (control group, 81 cases) and nursing intervention group (experimental group, 95 cases). The indexes of general condition, circumference of limbs and deep venous thrombosis were recorded and compared between the two groups during perioperative period. Results all patients received regular follow-up for at least 6 months. The probability of deep venous thrombosis was 8.42 in the nursing intervention group and 30.86 in the control group. The peripheral diameter of lower extremity in the nursing intervention group [10 cm: superior malleolus 10 cm: (20.37 卤0.66) cm; subpatellar 10 cm: (35.39 卤1.70) cm; suprapatellar 10 cm: (44.04 卤3.02) cm] was significantly lower than that in the control group [supramalleolar 10 cm: (23.62 卤0.99) cm; subpatellar 10 cm: (38.04 卤1.52) cm; suprapatellar 10 cm: (48.76 卤3.26) cm]. Conclusion during the perioperative period of major orthopedic surgery, scientific, rigorous and regular nursing intervention can obviously prevent thromboembolic diseases such as deep vein thrombosis and pulmonary embolism, which should be further popularized and adopted.
【作者单位】：第四军医大学唐都医院骨3科;济南军区总医院脊髓修复科;
【基金】：国家自然科学基金(81272441)
【分类号】：R473.6

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