胃癌根治术后下肢深静脉血栓形成的危险因素及护理对策

Analysis of therisk Factors of deep Venous Thrombosis of Lower Extremities after Gastrectomy and Nursing Strategy

目的探讨胃癌根治术后下肢深静脉血栓(DVT)形成的危险因素及护理对策。方法选取2010年1月至2016年5月于我院性根治手术治疗的140例胃癌患者作为研究对象,采用系统性回顾法分析其临床资料,按其术后是否发生下肢DVT分为A组(发生DVT)40例和B组(未发生DVT)100例,记录并比较2组患者性别、年龄、体重指数、既往疾病史、围手术期是否感染及有无中心静脉置管等临床资料,且采用非条件单因素和多因素logistic回归模型分析DVT形成的相关危险因素,并分析不同情况的患者应采取的护理措施。结果通过非条件单因素logistic回归模型分析可得,年龄(≥60岁)、冠心病史、静脉血栓史使用止血药物(有)及体重指数(>30 kg/m^2)可能为胃癌术后DVT的主要危险因素(P<0.05)。结论年龄(>60岁)、使用止血药物(有)及体重指数(>30 kg/m^2)为胃癌术后形成LEDVT的独立危险因素,且应根据患者的具体情况予以相应的护理干预措施。

Objective To investigate the risk factors and nursing strategies of deep vein thrombosis （DVT） after radical operation of gastric cancer. Methods 140 patients with gastric cancer who underwent radical surgery were selected as the subjects admitted to our hospital from January 2010 to May 2016. The clinical data were analyzed by systematic review. Those patients were divided into A group （DVT） in 40 cases and B group（ no DVT）in accordance with the occurrence of postoperative LEDVT. The clinical data of gender, age, body mass index, past history of disease,perioperative infection and central venous catheter were recorded and compared. The non-conditional univariate and multivariate logistic regression models were used to analyze the risk factors of LEDVT formation. Nursing interventions were also analyzed in patients with different conditions. Results The results of univariate logistic regression analysis showed that age （ ≥ 60 years ） , history of coronary heart disease,history of venous thrombosis and body mass index（ 〉 30 kg/m^2） may be the main factors leading to the formation of DVT （ P 〈 0. 05 ）. Conclusion Age （ 〉 60 years ）, use of hemostatic agents（BMI） and body mass index（ 〉 30 kg/m^2） are independent risk factors for the development of DVT in patients with gastric cancer. Nursing interventions should be provided according to the patients＇ specific conditions.