骨科大手术患者围手术期深静脉血栓预防策略研究

发布时间：2018-11-02 18:50

【摘要】：目的构建可供护理实践借鉴参考的骨科大手术患者围手术期深静脉血栓预防策略,用于指导护理具体情境,为骨科大手术患者深静脉血栓的护理预防提供循证依据。方法采用系统评价法系统检索国内外临床实践指南和原始研究,采用澳大利亚循证卫生保健中心质量评价方法和Johns Hopkins标准评鉴文献,总结归纳出骨科大手术患者深静脉血栓相关护理预防措施,初拟护理预防策略问卷,运用德尔菲法,通过两轮征询临床专家意见,提高最终证据策略的可操作性,便于临床证据应用。结果 111篇文献纳入最终研究,通过系统评价和德尔菲法,构建了包涵"风险评估""分级预防""教育指导"在内的3个维度、49项骨科大手术深静脉血栓护理预防策略。结论基于系统评价和德尔菲法构建的骨科大手术患者深静脉血栓护理预防策略具有较高的科学性、实用性和可操作性,可为护理实践提供客观、可借鉴的实施策略,有利于预防措施的有效实施。
[Abstract]:Objective to construct the perioperative deep venous thrombosis prevention strategy for the patients undergoing major orthopaedic surgery for reference in nursing practice so as to guide the nursing situation and provide evidence based basis for the nursing prevention of deep vein thrombosis in patients undergoing major orthopaedic surgery. Methods A systematic evaluation method was used to systematically search the clinical practice guide and original research at home and abroad, and the quality evaluation method of Evidence-Based Health Care Center in Australia and the Johns Hopkins standard were used to evaluate the literature. This paper summarizes the preventive measures of deep venous thrombosis related nursing care in patients undergoing major orthopaedic surgery, initially draws up a questionnaire on nursing prevention strategies, applies Delphi method, and through two rounds of consultation with clinical experts, improves the maneuverability of the final evidence strategy. It is convenient for clinical evidence application. Results 111 articles were included in the final study. Through systematic evaluation and Delphi method, three dimensions including "risk assessment", "graded prevention" and "education guidance" were constructed, and 49 major orthopaedic surgery deep venous thrombosis nursing strategies were constructed. Conclusion the preventive strategy of deep venous thrombosis for patients undergoing orthopaedic major surgery based on systematic evaluation and Delphi method is scientific, practical and operational, and can provide objective and useful strategies for nursing practice. It is beneficial to the effective implementation of preventive measures.
【作者单位】：南京中医药大学护理学院;南京中医药大学金陵临床医学院骨科;南京中医药大学金陵临床医学院卫生技术干部训练中心;常州市第一人民医院;
【基金】：江苏省科学技术厅社会发展面上项目(BE2015686)
【分类号】：R473.6

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