早期护理干预联合利伐沙班预防髋关节置换术后下肢深静脉血栓40例

Study on the Effect of Early Nursing Intervention Combined with Rivaroxaban for the Prevention of DVT after Total Hip Replacement in 40 Cases

目的观察早期护理干预模式对髋关节置换术(THR)术后应用利伐沙班治疗患者下肢深静脉静脉血栓(DVT)的预防效果。方法选取2012年1月至2013年12月选取80例术后应用利伐沙班治疗的髋关节置换术(THR)患者,根据随机数字表法将患者分为观察组及对照组,各40例,对照组围手术期间应用常规性护理,观察组则应用早期护理干预,对比分析两组患者干预前后活化部分凝血酶时间(APTT)、血浆凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血活酶时间(TT)及D-二聚体(D-D)水平的变化。观察两组患者治疗满意率及并发症发生情况。结果观察组治疗后TT,APTT及PT水平高于对照组,而FIB,D-D则低于对照组(P<0.05)。观察组DVT、泌尿感染、术后血肿、切口感染发生率低于对照组(P<0.05)。观察组患者治疗满意率为95.00%,高于对照组的72.50%(P<0.05)。结论早期护理干预模式可提高THR患者术后应用利伐沙班的依从性,改善血液黏稠度,促进血液循环,可有效预防DVT的发生。

Objective To observe the effect of early nursing intervention combined with rivaroxaban for the prevention of deep vein thrombosis（ DVT） after total hip replacement（ THR）. Methods 80 cases of postoperative rivaroxaban treatment after THR in our hospital from January to December 2013 were selected and divided into the observation group（ n = 40） and the control group（ n = 40） according to the random number table. The control group used the routine nursing care during the perioperative period. The observation group applied the early nursing intervention during the perioperative period. The changes of the activated partial thromboplastin time（ APTT）,prothrombin time（ PT）,fibrinogen（ FIB）,thromboplastin time（ TT） and D-dimer（ DD） level before and after intervention were compared between the two groups. The treatment satisfaction rate and the occurrence situation of complications were observed in the two groups. Results The levels of TT,APTT and PT after treatment in the observation group were higher than those in the control group;the differences showed the statistical significance（ P〈0. 05）,while the levels of FIB and DD were lower than those in the control group with statistical differences（ P〈0. 05）. The occurrence rates of DVT,urinary tract infection,postoperative hematoma and wound infection in the observation group were lower than those in the control group with statistical differences（ P〈0. 05）. The satisfaction rate of the observation group was 95. 00%, which was higher than 72. 50% in the control group; the difference was statistically significant（ P〈0. 05）.Conclusion Early nursing intervention model can increase the compliance of postoperative rivaroxaban application on patients with THR,improve the blood viscosity,promote the blood circulation and effectively prevent the occurrence of DVT.