围术期静脉血栓栓塞症分层预防清单的应用

Application of stratified prophylaxis list for perioperative venous thromboembolism

目的观察清单制管理在降低妇科围术期静脉血栓栓塞症(VTE)的效果。方法选择湖北省荆州市中心医院2017年1月至12月进行清单制管理的妇科围手术期632例患者作为试验组,以2016年1月至12月未开展清单制管理的妇科围手术期617例作为对照组。比较两组患者围术期静脉血栓栓塞症的发生情况。结果试验组在踝泵运动、下床活动、温水泡脚、穿弹力袜、充气加压装置使用、药物预防6项干预措施落实率均显著高于对照组(χ~2值分别为1533.28、1498.91、131.50、46.13、14.01、20.99,均P<0.01)。试验组632例患者中有2例(0.32%)发生VTE,对照组617例患者中有9例(1.46%)发生VTE,试验组显著低于对照组(χ~2=4.67,P<0.05)。结论清单制管理能有效地降低妇科围术期静脉血栓栓塞症的发生,保障患者的安全。

Objective To observe the effect of detailed list management in reducing venous thromboembolism(VTE)during the gynecological perioperative period.Methods A total of 632 patients with gynecological perioperative venous thromboembolism(VTE)treated by detailed list management during the period from January,2016 to December,2017 were taken as the experimental group,and 617 patients with gynecological perioperative venous thromboembolism(VTE)treated during the period from January,2016 to December,2016 were chosen as the control group.Results The patients in the experimental group showed a higher rate of implementation of the following measures than the control group,specifically,the movement of the ankle,the movement off the sickbed,bathing the feet in warm water,wearing the stretch stockings,and applying inflating and pressurizing device(χ~2=1,533.28,1,498.91,131.50,46.13,14.01,20.99,respectively,P<0.01).2 of the 632(0.32%)patients had VTE,but 9 of 617 patients(1.46%)in the control group,which showed that the experimental group had fewer patients with VTE than that the control group(χ~2=4.67,P<0.05).Conclusion Detailed list management can effectively reduce the occurrence of venous thromboembolism among the patients in gynecological perioperative period and ensure the safety of them.