心胸外科手术后下肢深静脉血栓形成的危险因素分析及护理干预研究

Analysis on risk factors of deep venous thrombosis after cardiothoracic surgery and study the nursing intervention

目的探讨分析心胸外科手术后下肢深静脉血栓形成的危险因素及其护理干预策略。方法回顾性分析本院2009年1月至2015年11月成功进行心胸外科手术的1580例患者临床资料,其中56例发生了下肢深静脉血栓,其他的病例设为对照组,比较两组患者的临床特征,运用logistic分析心胸外科手术后下肢深静脉血栓形成的相关危险因素,同时对发生下肢深静脉血栓的患者进行护理干预治疗及观察,分析防治方案。结果 1580例患者中有56例发生了下肢深静脉血栓,经过单因素条件logistic分析发现下肢深静脉血栓的危险因素为下肢骨折及骨科相关性疾病、脑血管病致卧床、恶性肿瘤、高血压、糖尿病、肥胖、长时间制动、静脉内应用刺激性强的药物、静脉内留置管道,多因素logistic分析发现长时间制动、静脉内应用刺激性强的药物及静脉内留置管道是诱发下肢深静脉血栓的独立危险因素。通过护理干预处理,患者症状得到了有效控制。结论影响心胸外科手术后下肢深静脉血栓形成是多因素作用的结果,对高危患者应当密切观察病情,给予规范化治疗及护理干预十分必要。

Objective To investigate the risk factors and nursing intervention strategies for deep venous thrombosis after cardiothoracic surgery.Methods A retrospective analysis on the datas of 1580 patients received successful cardiothoracic surgery into our hospital during January 2009 and November 2015 was done. The 56 cases of deep vein thrombosis patients were enrolled in the study group,the other cases as control group. The clinical characteristics of the patients were compared. Using the relevant risk factors logistic analysis to explore the risk factors of deep venous thrombosis after cardiothoracic surgery. Meanwhile,applied nursing intervention to the patients with deep venous thrombosis and observed the effects,analyzed prevention and treatment programs.Results Deep venous thrombosis occurred in 56 cases of patients. Univariate conditional logistic analysis indicated that lower extremity fractures and orthopedic- related diseases,cerebrovascular disease bedridden,cancer,high blood pressure, diabetes, obesity, prolonged braking, intravenous strong irritant drug use,intravenous catheter were the risk factors of the occurrence of deep vein thrombosis. Multivariate logistic regression analysis showed that prolonged braking,intravenous application of strong irritant drugs and intravenous catheter conduit were the independent risk factor of deep vein thrombosis. By nursing intervention treatment,the symptoms have been effectively controlled.Conclusions The impact of deep venous thrombosis after cardiothoracic surgery is the result of multiple factors,high- risk patients should be closely observed,give the standard treatment and nursing intervention is necessary.