行动研究法在预防脑出血患者围术期深静脉血栓形成中的应用

Effects of action research on preventing perioperative deep venous thrombosis form in patients with intracerebral hemorrhage

目的：评价行动研究法在预防脑出血患者围术期深静脉血栓形成中的效果。方法选取2011—2014年入住神经外科的93例脑出血患者,将2011—2012年收治的45例患者设为对照组,2013—2014年收治的48例患者设为干预组。对照组采用神经外科一般护理常规及围术期护理常规,干预组在常规护理基础上,对其应用行动研究法进行下肢活动干预,即以计划、行动、观察、反思4个步骤进行螺旋式循环后,制定下肢活动方案并实施。观察两组患者的深静脉血栓发生率、再出血率。结果干预组DVT和再出血发生率均为0,显著低于对照组的13.33%（6/45）和4.44%（2/45）,DVT发生率比较差异有统计学意义（P〈0.01）,再出血率差异无统计学意义（P〉0.05）。结论行动研究法运用于脑出血患者围术期下肢活动方案中,能够有效降低深静脉血栓的发生率。

Objective To assess the effects of action research on preventing perioperative deep venous thrombosis （ DVT ） form in patients with intracerebral hemorrhage. Methods We selected 93 cases of intracerebral hemorrhage in Neurosurgery of our hospital from 2011 to 2014. A total of 45 cases, who hospitalized from 2011 to 2012, were selected as control group and received routine nursing and perioperative routine nursing, while 48 cases, who hospitalized from 2013 to 2014, were chosen as treatment group and received action research to intervened legs exercise with four steps including plan, action, observation and reflection based on nursing of control group. Then after four steps spiral cycle, we made the plan of lower extremities excise and implemented. The incidences of DVT and rehaemorrhagia in two groups were observed. Results The rate of DVT and rehaemorrhagia were 0 in the treatment group, which were significantly lower than 13. 33% （6/45） and 4. 44% （2/45） respectively in the control group （P〈0. 05）. The coagulation index changes had no significantly difference between two groups. The difference of DVT had statistical significance between two groups （P〈0. 01）, but the difference of rehaemorrhagia had no statistical significance between two groups （P〉0. 05）. Conclusions Action research method is applied for plan of perioperative lower extremities excise in patients with intracerebral hemorrhage, which can decline the incidence of DVT.