股骨骨折患者深静脉血栓形成的影响因素及护理对策

Influencing factors and nursing countermeasures of deep venous thrombosis in patients with femoral fracture

目的分析股骨骨折患者深静脉血栓(DVT)形成的影响因素,并探讨预防与护理对策。方法回顾性分析2014年1月至2017年11月山东省立第三医院骨科收治的180例股骨骨折患者的临床资料,统计深静脉血栓的发生率,采用单因素分析股骨骨折患者术后DVT形成的相关因素,采用Logistic多元回归分析法对股骨骨折患者DVT形成的影响因素进行分析。结果 180例患者中发生DVT 19例,DVT发生率为10.6%。单因素分析结果显示,年龄、体质量指数(BMI)、吸烟史、合并高血压和糖尿病史、凝血功能、术后是否给予抗凝护理与股骨骨折术后DVT形成有关(P<0.05);Logistic回归分析结果显示,高龄、糖尿病、凝血功能差、术后未采取抗凝护理是导致股骨骨折术后形成DVT的影响因素(P<0.05)。结论高龄、糖尿病、凝血功能差、术后未采取抗凝护理是股骨骨折并发深静脉血栓形成的相关因素,给予预防性静脉血栓抗凝护理可有效降低DVT的发生风险。

Objective To analyze the influencing factors of deep venous thrombosis（DVT） in patients with femoral fracture, and to explore its prevention and nursing countermeasures. Methods The clinical data of 180 patients with femoral fractures admitted to the Department of Orthopedics in Shandong Provincial Third Hospital from January2014 to November 2017 were reviewed retrospectively. The incidence of DVT was counted. The factors related to the formation of postoperative DVT in patients with femoral fractures were analyzed by single factor analysis, and its influencing factors were analyzed by Logistic multiple regression analysis. Results Of the 180 patients, 19（10.6%） had DVT. The results of single factor analysis showed that age, body mass index（BMI）, smoking history, history of combined hypertension and diabetes, coagulation and postoperative anticoagulation were related to DVT formation after femoral fractures（P〈0.05）. The results of Logistic regression analysis showed that the elderly, diabetes, poor coagulation function and no postoperative anticoagulation care were the influencing factors of DVT formation after femoral fracture surgery（P〈0.05）. Conclusion Elderly, diabetes, poor coagulation function, and no postoperative anticoagulation care are related factors of femoral fracture complicated with deep venous thrombosis. Anticoagulant nursing for prophylactic venous thrombosis can effectively reduce the risk of DVT.