护理干预在创伤患者静脉血栓栓塞症(VTE)预防中的作用探讨

The Role of Nursing Intervention in the Prevention of Venous Thromboembolism(VTE) in Trauma Patients

目的探讨护理干预在创伤患者静脉血栓栓塞症(VTE)预防中的临床作用。方法选取2017年9月-2018年9月收治的大手术及创伤患者90例按照护理方法分为两组,每组45例,对照组采用常规护理,观察组行针对性护理干预。结果干预后,观察组血小板计数(243.26±78.21)×109/L vs (205.14±92.15)×109/L、血红蛋白比值(2.32±0.67)×109/L vs(1.97±0.82)×109/L及血糖水平(7.84±1.73)mmol/L vs (7.15±1.32)mmol/L等降低幅度均明显大于对照组(t=2.254、2.217、2.127,P<0.05)。观察组凝血指标D-D(8.70±3.23)mg/L vs (6.54±2.13)mg/L、FIB(3.13±0.68)g/L vs (2.77±0.86)g/L、PT(11.42±1.15)s vs(12.62±1.25)s和APTT(30.71±3.25)s vs(33.11±4.33)s的改变幅度均明显大于对照组(t=3.222、2.203、4.739、2.974,P<0.05),股静脉血流速度护理1周(30.4±8.2)cm/s与2周(38.5±2.7)cm/s提高幅度明显大于对照组(t=6.423,10.606,P<0.05)。观察组的患肢肿痛、VTE和DVT发生率分别为31.11%、11.11%和6.67%,均明显低于对照组(χ^2=8.750,4.444,4.406,P<0.05)。结论给予创伤患者针对性的护理干预,能够有效控制静脉血栓栓塞症的形成,具有非常显著的临床应用效果。

Objective To investigate the clinical role of nursing intervention in the prevention of venous thromboembolism(VTE) in trauma patients. Methods A total of 90 patients with major surgery and trauma from September 2017 to September 2018 were enrolled according to the nursing method. Each group consisted of 45 patients. The control group received routine nursing and the observation group underwent targeted nursing intervention. Results After intervention, the platelet count of the observation group(243.26±78.21)×109/L vs(205.14±92.15)×109/L, hemoglobin ratio(2.32±0.67)×109/L vs(1.97±0.82)×109/L and blood glucose level(7.84±1.73)mmol/L vs(7.15±1.32)mmol/L was significantly greater than that of the control group(t=2.254, 2.217, 2.127, P<0.05). Observation group coagulation index D-D(8.70 ±3.23)mg/L vs(6.54 ±2.13)]mg/L, FIB(3.13 ±0.68)g/L vs(2.77 ±0.86)g/L, PT(11.42 ±1.15)s vs(12.62 ±1.25)s and APTT(30.71±3.25)s vs(33.11±4.33)s were significantly greater than those of the control group(t=3.222, 2.203, 4.739,2.974, P<0.05), femoral venous flow velocity increase of 1 week(30.4±8.2) cm/s and 2 weeks(38.5±2.7) cm/s was significantly higher than that of the control group(t=6.423, 10.606, P<0.05). The incidence of swelling, pain, VTE and DVT in the observation group were 31.11%, 11.11% and 6.67%, respectively, which were significantly lower than the control group(χ^2=8.750, 4.444, 4.406, P<0.05). Conclusion Targeted nursing intervention for trauma patients can effectively control the formation of venous thromboembolism, and has a very significant clinical application effect.