剖宫产围手术期下肢深静脉血栓形成的相关因素及护理措施

Related factors and nursing measures for lower extremity deep venous thrombosis in the perioperative period of cesarean section

目的探讨剖宫产围手术期下肢深静脉血栓形成(LEDVT)的相关因素,总结护理措施,以期望为临床上采取积极的措施降低LEDVT发生率提供依据。方法选择2014年1月至2017年10月期间于雅安市人民医院妇产科住院的80例剖宫产术后LEDVT患者为研究对象,并将其纳入观察组,选择同期未合并LEDVT的健康产妇80例纳入对照组,对可能影响LEDVT的相关因素进行Logistic多因素逐步回归分析,主要因素包括年龄、体重指数(BMI)、产次,是否有吸烟史、饮酒史、口服避孕药物史、是否经常参加体育锻炼,以及基础疾病情况如糖尿病、高血压病史以及血清D-二聚体、C反应蛋白(CRP)水平。结果单因素分析结果显示,LEDVT的发生与BMI、吸烟史、体育锻炼、高血压、糖尿病、D-二聚体及CRP有关(P<0.05);Logistic多因素逐步回归分析结果显示,BMI、吸烟、D-二聚体是LEDVT形成的独立危险因素(P<0.05)。结论剖宫产术后LEDVT的发生与BMI、吸烟、D-二聚体水平有关,加强围手术期术后的护理对减少LEDVT的发生有利。

Objective To explore the related factors of lower extremity deep venous thrombosis（LEDVT） in the perioperative period of cesarean section and summarize the nursing measures, so as to provide evidence for taking active measures to reduce the incidence rate of LEDVT. Methods A total of 80 cases of LEDVT patients who were hospitalized in Ya’an People’s Hospital from January 2014 to October 2017 were selected as the subjects. The healthy women without LEDVT were randomly selected into the control group, and the related factors that might affect LEDVT were statistically analyzed（multi-factor stepwise logistic regression analysis）. The main factors included age, body mass index（BMI）, birth order, history of smoking, drinking history, history of oral contraceptives, regular physical exercise, and basic diseases such as diabetes, hypertension, and serum D-dimer, and C reactive protein（CRP）. Results Univariate analysis showed that the occurrence of LEDVT was associated with BMI, smoking history, physical exercise, hypertension, diabetes, D-dimer and CRP（P〈0.05）. Multi-factor stepwise logistic regression analysis showed that smoking, BMI, D-dimer were independent risk factors to the LEDVT（P〈0.05）. Conclusion The incidence of LEDVT after cesarean section is related with BMI, smoking and D-dimer. Strengthening perioperative nursing is beneficial to reduce the incidence of LEDVT.