早期护理干预对急诊创伤患者小腿肌间静脉血栓的预防作用

Clinical value of early nursing intervention on calf muscular vein thrombosis in acute trauma patients

目的评估急性创伤患者住院期间护理干预对肌间静脉血栓发生及预防影响。方法收集常州市武进人民医院急诊科2021年上半年收治入院的急诊创伤患者共222人,其中男性127例,女性95例;年龄14~95岁,平均(54.12±18.04)岁。根据知情同意原则分为加强护理组和对照组:加强护理组82例,其中男性51例,女性31例;年龄15~94岁,平均(51.24±18.22)岁。对照组140例,其中男性76例,女性64例;年龄14~95岁,平均(55.81±17.86)岁。加强护理组患者入院后除接受常规护理外,增加更高频率主被动踝泵运动及下肢肌肉泵收缩,比较两组患者在彩超检查肌间静脉血栓检出率、凝血功能指标等变化。结果加强护理组患者肌间静脉血栓发生显著低于对照组(P<0.05),也能降低创伤患者术后血栓发生率,并明显降低D-二聚体(P<0.05),而并不影响患者其他PT(prothrombin time, PT),APTT(activated partial thromboplastin time, APTT)、纤维蛋白原等凝血指标。结论对急诊创伤患者住院期间行更高频率,更大强度的下肢护理干预,能降低住院期间肌间静脉血栓发生率。

Objective To evaluate the effect of nursing intervention on the occurrence and prevention of intermuscular venous thrombosis in patients with acute trauma. Methods 222 emergency trauma patients admitted to the emergency department of Changzhou Wujin people’s Hospital in the first half of 2021 were collected, including 127 males and 95 females;The age ranged from(14-95)years, with an average of(54.12±18.04) years. According to the principle of informed consent, they were divided into intensive care group and control group: 82 cases in intensive care group, including 51 males and 31 females;The age ranged from(15-94)years, with an average of(51.24±18.22) years. 140 cases in the control group, including 76 males and 64 females;The age ranged from(14-95)years, with an average of(55.81±17.86) years. In addition to routine nursing, patients in the intensive nursing group received higher frequency active and passive ankle pump exercise and lower limb muscle pump contraction after admission. The differences in the detection rate of intermuscular venous thrombosis and coagulation function indexes between the two groups were compared. Results The incidence of intermuscular venous thrombosis in the intensive care group was significantly lower than that in the control group(P<0.05). It could also reduce the incidence of postoperative thrombosis and D-dimer in trauma patients(P<0.05), without affecting other coagulation indexes such as Pt(prothrombin time), APTT(activated partial thromboplastin time), fibrinogen and so on. Conclusion Higher frequency and greater intensity of lower limb nursing intervention for emergency trauma patients during hospitalization can reduce the incidence of intermuscular venous thrombosis during hospitalization.