连续性动态评估预防膝关节置换术后下肢静脉血栓的护理研究

Continuous Dynamic Evaluation in the Prevention of Deep Vein Thrombosis After Knee Arthroplasty

目的探讨运用连续性动态评估对预防膝关节置换术后下肢静脉血栓（DVT）形成的护理研究结果。方法将61例膝关节置换术后患者随机分为对照组28例和观察组33例,对照组接受常规护理预防,观察组采用连续动态评估方法进行干预护理。比较两组术后血流动力学指标、D-二聚体水平、DVT发生率、疼痛分度及护理满意度。结果术后第4、7天,观察组股静脉平均血流速度分别为（26.91±5.42）cm/s、（35.25±4.79）cm/s,优于对照组（24.05±4.51）cm/s、（27.89±5.03）cm/s,差异具有统计学意义（P〈0.05）。术后5~7天观察组血浆D一二聚体水平低于对照组（P〈0.05）。观察组DVT发生率（6/33）低于对照组（13/28）,差异具有统计学意义（P〈0.05）。观察组护理满意度及疼痛评分均优于对照组（P〈0.05）。结论连续性动态评估干预策略可有效改善膝关节置换术后下肢静脉循环,降低DVT发生率,提高护理满意度。

Objective To explore the effect of continuous dynamic assessment on the prevention of lower extremity venous thrombosis（DVT） after knee arthroplasty. Methods 61 patients with knee replacement were randomly divided into control group（n=28） and observation group（n=33）. The control group received routine nursing prevention. The observation group was treated by continuous dynamic evaluation. The hemodynamic parameters, D-dimer level, DVT incidence, pain index and nursing satisfaction were compared between the two groups. Results On the 4th and 7th day after operation, the mean blood flow velocity of the femoral vein was（26.91±5.42） cm/s and（35.25 ± 4.79） cm/s, respectively, which was better than that of the control group（24.05±4.51） cm/s,（27.89 ± 5.03） cm/s, the difference was statistically significant（P 〈 0.05）. The levels of plasma D-dimer in the observation group were lower than those in the control group（P〈0.05）. The incidence of DVT in the observation group（6/33） was lower than that in the control group（13/28）, the difference was statistically significant（P〈0.05）. The scores of nursing care and pain in the observation group were better than those in the control group（P〈0.05）. Conclusion Continuous dynamic assessment of intervention strategies can effectively improve posterior knee venous circulation after knee replacement, reduce the incidence of DVT, improve nursing satisfaction.