PDCA循环管理对神经系统危重病例下肢深静脉血栓形成的影响及患者自我效能与依从性研究

Impact of PDCA cycle management on the lower extremity deep vein thrombosis of critical patients in neurology and the patients'self-efficacy and compliance

目的探究PDCA循环管理对神经内科危重病例下肢深静脉血栓(DVT)形成及患者自我效能与依从性的影响。方法2020年2月至2021年2月本院神经内科危重患者178例,随机分为对照组(常规管理,n=89)、观察组(PDCA循环管理,n=89)。比较两组DVT发生率、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、股静脉血流平均速度、股静脉血流峰速、自我效能及依从性差异。结果观察组DVT发生率显著低于对照组(P<0.05)。管理前两组APTT、PT、TT及Fbg差异比较均无明显统计学意义(P>0.05),管理后APTT、PT及TT均显著增加,Fbg均显著减少,且观察组变化趋势更显著(P<0.05)。管理前两组股静脉血流平均速度、股静脉血流峰速差异比较均无明显统计学意义(P>0.05),管理后股静脉血流平均速度、股静脉血流峰速均显著增加,且观察组增加更显著(P<0.05)。管理前两组自我效能差异比较无明显统计学意义(P>0.05),而管理后自我效能与依从性均显著增加,且观察组增加更显著(P<0.05)。结论使用PDCA循环管理能有效预防神经内科危重患者DVT发生,加速股静脉血流速度,改善凝血功能,提高患者自我效能及依从性。

Objective Explore the impact of PDCA management on deep venous thrombosis(DVT)of lower limbs in critical cases of neurology department as well as its self-efficacy and compliance.Methods 178 critically patients of our hospital in neurology department from February 2020 to February 2021 were stochastically divided into control(routine management,n=89)and observation group(PDCA management,n=89).Between the two groups,incidence of DVT,activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fbg),average velocity and peak velocity of femoral vein blood flow,self-efficacy and compliance were compared.Results Incidence of DVT in observation group was remarkablely lower than control(P<0.05).APTT,PT,TT and Fbg has no statistically remarkable differences before management between the two(P>0.05),nevertheless,APTT,PT and TT were remarkablely increased as well as Fbg reduced after management,the variation trend in observation group was more outstanding(P<0.05).Average velocity and peak velocity of femoral vein blood flow has no noteworthy difference between the two while increased memorably after management,the increase in observation group was more remarkable(P<0.05).Self-efficacy and compliance has no prominent difference between the two before management(P>0.05),but which increased dramatically after management,the increase in observation group was more arresting(P<0.05).Conclusions PDCA management restrain the occurrence of DVT effectively in critically ill patients in department of neurology and accelerate femoral vein blood flow velocity,improve coagulation function as well as the patients'self-efficacy and compliance.