以血栓弹力图为指导预防创伤骨折术后静脉血栓栓塞的护理研究

Nursing study on prevention of vein thromboembolism after trauma fracture operation under the guidance of thromboela-stogram

目的探讨血栓弹力图(TEG)指导下创伤骨折术后静脉血栓栓塞(VTE)形成的预防护理措施。方法选取2019年9—12月我院接受治疗的创伤骨折患者96例为研究对象,将其随机等分为干预组和对照组,对照组予以常规护理,干预组在常规护理基础上,实施TEG指导下的临床护理干预,比较两组治疗前与术后7 d VTE发生率,治疗前与术后1,3 d和1周TEG指标[反应时间(R)、凝血时间(K)、最大振幅(MA)、α角]和凝血状态。结果干预组VTE发生率明显低于对照组,差异有统计学意义(P<0.05);治疗前,两组TEG指标比较差异无统计学意义(P>0.05);两组术后各段时间TEG指标与治疗前比较差异有统计学意义(P<0.05);治疗前,两组凝血正常率比较差异无统计学意义(P>0.05);干预组术后各时间段凝血状态正常率显著高于对照组,差异有统计学意义(P<0.05)。结论TEG检测指导下对创伤形骨科予以不同围术期护理干预措施,能有效改善血液凝血状态,促进凝血功能恢复正常,能显著降低术后VTE发生率。

Objective To discuss the preventive and nursing measures of vein thromboembolism(VTE)formation after trauma fracture under the guidance of thromboela-stogram(TEG).Methods We selected 96 cases of trauma fracture patients who received treatment in our hospital from September to December 2019 as the study objects,and they were randomly divided into an intervention group and a control group.The control group was given routine nursing,and the intervention group was implemented clinical nursing intervention under the guidance of TEG on the basis of routine nursing.The incidence of VTE before treatment and 7 days after operation,TEG indicators[reaction time(R),coagulation time(K),maximum amplitude(MA),αangle]before treatment and 1,3 days and 1 week after treatment,and coagulation status were compared between the two groups.Results The incidence of VTE in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in TEG indicators between the two groups before the treatment(P>0.05).There were statistically significant differences in the TEG indexes from the comparison between at each postoperative period and those before treatment in the two groups(P<0.05).There was no statistically significant difference in normal rate of coagulation between the two groups before the treatment(P>0.05).The normal rate of coagulation status in the intervention group was significantly higher than that in the control group at each time period after operation,and the differences were statistically significant(P<0.05).Conclusion Different perioperative nursing interventions for trauma orthopedics under the guidance of TEG detection can effectively improve blood coagulation status,promote coagulation function to return to normal,and can significantly reduce the incidence of postoperative VTE.