产褥期并发深静脉血栓形成危险因素及护理体会

Risk Factors and Nursing Experience of Puerperal deep Venous Thrombosis

目的探讨产褥期并发深静脉血栓形成(DVT)危险因素及护理体会。方法回顾性分析2011年2月至2013年9月我院收治的120例产褥期并发DVT患者及90例不伴有DVT患者临床资料,采用单因素及多因素回顾性分析产褥期并发DVT形成危险因素,观察产褥期并发DVT患者护理干预前后凝血功能[活化部分凝血活酶时间(a PTT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)]变化及DVT复发率。结果研究组妊娠期高血压、卧床休息时间≥6 d、口服避孕药史、剖宫产史、产后出血所占百分比明显高于对照组(P<0.05);妊娠期高血压、卧床休息时间≥6 d、口服避孕药史、剖宫产史是产褥期并发DVT形成的独立危险因素(P<0.05);护理干预后a PTT、PT、Fbg与对照组比较无明显差异;护理干预后干预组DVT复发率4.44%明显低于对照组22.22%(P<0.05)。结论产褥期并发DVT形成危险因素较多,依据其危险因素为患者实施综合性护理干预可降低DVT发生率。

Objective To investigate the risk factors and nursing experience of puerperal deep venous thrombosis（DVT）. Methods The clinical data of 120 patients with puerperal DVT who were admitted to our hospital between February 2011 and September 2013 were analyzed retrospectively. The risk factors of puerperal DVT were analyzed by univariate and multivariate retrospective analysis. Changes of blood coagulation function [ activated partial thromboplastin time （ aPTT）, prothrombin time （ PT）, fibrinogen （Fbg） ] before and after nursing and the recurrence rate of DVT were observed. Results The proportions of patients with hypertensive disorder complicating pregnancy, whose stay in bed ≥ 6 d, with oral administration of contraceptives, history of cesarean section and postpartum hemorrhage in the study group were significantly higher than those in control group （P 〈 0.05） ;Hypertensive disorder complicating pregnancy, stay in bed ≥ 6 d, oral administration of contraceptives and history of cesarean section were the independent risk factors of puerperal DVT（P 〈 0.05 ） ; After nursing intervention, aPTT, PT and Fbg compared with the control group no significant difference. After nursing intervention, the recurrence rate of DVT in the intervention group （4.44%） was significantly lower than that in control group （22.22%） （ P 〈 0.05 ）. Conclusion There are many risk factors of puerperal DVT. The implementation of comprehensive nursing based on the risk factors can reduce the incidence of DVT.