VTE防控体系在预防骨科大手术围手术期VTE中的作用

发布时间：2018-01-30 12:05

本文关键词： VTE防控体系骨科大手术围手术期风险评估临床干预　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文选取目前常用的风险评估模型进行临床应用,通过对骨科手术患者进行围手术期VTE风险评估,以及临床干预,并对干预效果进行观察,对于今后如何降低VTE在骨科大手术患者中的发病提供参考意见。方法:应用非随机非同期对照试验法,选取广西医科大学第一附属医院自2011年1月至2013年6月在未实行VTE风险评估与干预时收治的并具有完整记录的骨科大手术患者共计368例作为参照组;自2013年7月至2016年1月在已实行VTE风险评估与临床干预后收治的并具有完整记录的骨科大手术患者共413例作为干预组。参照“中国骨科大手术静脉血栓栓塞症预防指南[1]”中的caprini评分回顾评估参照组及干预组患者的围手术期静脉血栓栓塞危险分度。将患者围手术期是否发生DVT和PTE作为观察指标。根据病例及回访综合对比分析。结果:干预组有1例肺栓塞发生,未干预组有10例肺栓塞发生,未干预组VTE的发生率明显高于干预组VTE的发生率。两组之间相比较VTE总发生率具有差异,有统计学意义(P0.05)。两组组内对比围手术期VTE风险评估,危险程度越高,其VTE的发生率就越高(P0.05)。结论:围手术期VTE风险评估后危险程度越高的患者,其VTE的发生率就越高;围手术期对骨科手术患者进行VTE风险评估并进行临床干预,可极大的减少患者罹患VTE的风险。
[Abstract]:Objective: this article selects the current commonly used risk assessment model for clinical application, through the perioperative VTE risk assessment of orthopaedic patients, as well as clinical intervention, and observe the effect of intervention. For how to reduce the incidence of VTE in orthopedic patients in the future. Methods: a non-randomized, non-synchronous controlled trial was used. From January 2011 to June 2013, the first affiliated Hospital of Guangxi Medical University was selected from the first affiliated Hospital of Guangxi Medical University to treat 368 patients with complete records of major orthopaedic surgery without VTE risk assessment and intervention. As a reference group; From July 2013 to January 2016, a total of 413 cases of orthopedic major orthopedic surgery patients treated after VTE risk assessment and clinical intervention were treated as the intervention group. Guidelines for the Prevention of Venous Thrombosis in Major Orthopaedic surgery in China. [1] " The perioperative risk of venous thromboembolism (VTE) in the reference group and the intervention group was evaluated retrospectively. Whether DVT and PTE occurred during the perioperative period was used as the index. Comprehensive comparative analysis of return visits. Results:. Pulmonary embolism occurred in 1 case in the intervention group. There were 10 cases of pulmonary embolism in the non-intervention group, and the incidence of VTE in the non-intervention group was significantly higher than that of the VTE in the intervention group, and there was a difference in the total incidence of VTE between the two groups. Compared with perioperative VTE risk assessment, the higher the risk level of the two groups. Conclusion: the higher the risk level of perioperative VTE risk assessment, the higher the incidence of VTE. Perioperative VTE risk assessment and clinical intervention in orthopedic patients can greatly reduce the risk of VTE.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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