协同护理在预防老年人工髋关节置换术后患者下肢深静脉血栓形成中的应用

Application of Collaborative Nursing in the Prevention of Deep Venous Thrombosis of Lower Limbs in Elderly Patients after Hip Arthroplasty

目的:探讨协同护理在预防老年人工髋关节置换术(HA)术后患者下肢深静脉血栓形成(DVT)中的应用效果。方法:将84例老年HA患者随机分为干预组和对照组各42例,对照组接受常规血栓预防措施,干预组在对照组基础上进行协同护理干预。比较两组干预前后DVT预防相关知识得分、髋关节功能(Harris)评分及优良率、腓肠肌疼痛(Homan征)发生率和下肢彩色多普勒超声检查DVT发生率。结果:干预后干预组患者DVT预防相关知识得分高于对照组(P<0.01);干预组髋关节功能Harris评分(86.5±10.8)分,高于对照组(80.8±11.7)分,比较差异有统计学意义(t=2.330,P=0.022);干预组术后髋关节功能优良率为78.6%,对照组为57.1%,两组比较差异有统计学意义(χ2=4.421,P=0.035);干预组Homan征发生率为2.4%,对照组为11.9%,两组比较差异无统计学意义(P>0.05);下肢彩色多普勒超声检查结果显示,干预组DVT发生率为7.1%,对照组DVT发生率为23.8%,两组比较差异有统计学意义(χ2=4.459,P=0.035)。结论:协同护理能够提高老年HA术后患者DVT预防相关知识水平,改善髋关节功能,对预防患者下肢DVT的发生起到积极作用。

Objective:To explore the effect of collaborative nursing in the prevention of deep venous thrombosis(DVT)of lower limbs in elderly patients after hip arthroplasty(HA).Methods:A total of 84 elderly HA patients were randomly divided into the intervention group and the control group with 42 cases each.The control group received routine thrombus prevention measures,and the intervention group carried out coordinated nursing intervention on the basis of the control group.Before and after intervention,knowledge score of DVT prevention,hip joint function(Harris)score,excellent and good rate,incidence of gastnemius pain(Homan sign)and incidence of DVT detected by color Doppler ultrasound were compared between the two groups.Results:The score of DVT prevention knowledge in the intervention group was higher than that in the control group(P<0.01).The Harris score of hip joint function in the intervention group(86.5±10.8)was higher than that in the control group(80.8±11.7),and the difference was statistically significant(t=2.330,P=0.022).The excellent and good rate of postoperative hip joint function in the intervention group was 78.6%,while that in the control group was 57.1%.The difference between the two groups was statistically significant(χ2=4.421,P=0.035).The incidence of Homan sign was 2.4%in the intervention group and 11.9%in the control group,and the difference between the two groups was not statistically significant(P>0.05).The results of lower limb color Doppler ultrasound showed that the incidence of DVT in the intervention group was 7.1%,while that in the control group was 23.8%.The difference between the two groups was statistically significant(χ2=4.459,P=0.035).Conclusion:Collaborative nursing can increase the knowledge level of DVT prevention in elderly HA patients after hip arthroplasty,improve the function of hip joint and play a positive role in preventing the occurrence of DVT in lower limbs.