专科护理对关节置换术围术期深静脉血栓的预防作用

Preventive effect of special nursing on perioperative deep vein thrombosis after joint replacement

目的探讨专科护理对关节置换术围术期深静脉血栓（DVT）的预防作用。方法选取2012年1-6月的45例关节置换患者为对照组，围术期采用关节置换常规护理；选取2012年7～12月的45例关节置换患者为观察组，围术期在关节置换常规护理基础上采用专科护理，包括采用Autar量表式进行前瞻性的分析、评估，筛选出中、高风险患者。制订防范的优先行动计划，同时进行护理干预措施，重视疼痛管理，早期提供功能训练椅及循环驱动冰桶冷敷仪联合弹力绷带、圆筒垫、沙袋、进行个案护理。三级护理质量监控，比较两组的Homans征、Neuhof征、DVT发生率、健康教育知识评分及护理满意度。结果观察组的Homans征、Neuhof征、DVT发生率均低于对照组，健康教育知识评分及护理满意度均高于对照组。差异有统计学意义（P〈0．05）。结论有预见性、有计划性地采用专科护理预防，可提高护理管理的科学性和客观性，有效预防关节置换术后DVT的发生。

Objective To investigate preventive effect of special nursing on perioperative deep vein thrombosis （DVT） after joint replacement. Methods 45 cases of patients with joint replacement from January 2012 to June 2012 were selected as control group,perioperative conventional joint replacement nursing was used in control group.45 cases of patients with joint replacement from July 2012 to December 2012 were selected as observation group,special nursing was used in observation group basis on perioperative conventional joint replacement nursing,including forward-looking analysis,evaluation were provided by Autar scale,medium and high risk patients were filtered,priority action plan for the prevention and nursing intervention was implemented,focus on pain management,early functional training instrument for chairs and loop-driven ice bucket ice combined with elastic bandage,drum pads,punching bag,care,three-level nursing quality control were provided.Homans,Neuhof, DVT incidence rate,health education score and nursing satisfaction rate in two groups was compared respectively. Results Homans,Neuhof, DVT incidence rate in observation group was lower than that in control group respectively,health education score and nursing satisfaction rate in observation group was higher than that in control group respectively,with statistical difference （P〈0.05）. Conclusion Predictable and planned special nursing applied in prevention,can improve the scientific and objective of nursing management,effectively prevent perioperative DVT after joint replacement.