人工膝关节置换术后深静脉血栓形成的预防和护理研究

Research on Prevention and Nursing of Formation of Deep Venous Thrombosis after Total Knee Arthroplasty

目的：观察人工膝关节置换术后深静脉血栓形成的预防和护理效果。方法：选取2013年10月-2015年9月期间于广州市第一人民医院关节外科收治的人工膝关节置换术患者88例作为研究样本,按随机原则分为两组,每组各44例,其中对照组患者实施常规护理,观察组患者在此基础上实施整体护理,观察并记录两组患者的术后引流量、手术前后静脉血流峰速度和平均速度,以及术后形成深静脉血栓发生率,比较两组患者的护理效果。所得数据采用统计学软件SPSS22.0建模并分析处理。结果：两组患者在术后引流量、术前静脉血流平均速度和峰速上均无明显区别,差异均不具统计学意义（P〉0.05）。两组患者的术后静脉血流平均速度和峰速均明显高于术前,差异均具统计学意义（P〈0.05）。观察组患者的术后静脉血流平均速度和峰速均明显高于对照组,差异均具统计学意义（P〈0.05）。观察组患者的术后形成深静脉血栓的发生率明显低于对照组,差异具统计学意义（P〈0.05）。结论：在常规护理的基础上实施整体护理,能有效预防人工膝关节置换术后深静脉血栓的形成,且对术后引流量无显著影响,值得临床上进一步优化应用。

Objective： To observe the prevention and nursing effect on the formation of deep venous thrombosis after total knee arthroplasty. Methods： 88 patients with senile knee replacement surgery who were treated in joint surgery in Guangzhou First Peoples Hospital between October 2013 and September 2015 were selected as research samples. They were divided into two groups according to the voluntary principle and there were 44 patients in each group. Patients in control group were given routine nursing and patients in observation group were applied overall nursing on the basic of that. Postoperative drainage volume, peak velocity and average velocity of venous flow before and after operation, incidence of the formation of deep venous thrombosis of patients in the two groups were observed and record and nursing effect was compared. All the data was modelled and analysed by statistical software SPSS22.0. Results： There was no significant difference between postoperative drainage volume and peak velocity and average velocity of venous flow before operation of the two groups and the difference had no statistical significance（P〉0.05）. Peak velocity and average velocity of venous flow after operation of the two groups were significantly higher than those before operation and the difference had statistical significance（P 〈0.05）. Peak velocity and average velocity of venous flow after operation of observation group were significantly higher than those of control group and the difference had statistical significance（P 〈 0.05 ） .Incidence of the formation of deep venous thrombosis after operation of observation group was significantly lower than that of control group and the difference and statistical significance（P 〈0.05）, Conclusion： Applying overall nursing on the basis of routine nursing can effectively prevent the formation of deep venous thrombosis after total knee arthroplasty and has no significant effect on postoperative drainage volume. It deserves further optimization and application clinically.