肾肿瘤切除术后下肢静脉血栓形成的预防性护理干预

Nursing intervention in prevention of phlebothrombosis of lower limbs after renal tumor resection

目的观察基于层次分析法的护理干预对肾肿瘤切除术后下肢静脉血栓形成的预防效果。方法回顾性分析本院2017年10月—2019年10月收治的80例肾肿瘤切除术患者的相关资料。以基于层次分析法的护理干预应用时间为分组依据,将2017年10月—2018年9月应用常规护理干预的患者设为对照组(n=34),将2018年10月—2019年10月应用基于层次分析法的护理干预患者设为研究组(n=46)。比较2组患者康复相关指标,干预后凝血及纤维蛋白溶解指标,干预前后生活质量,并发症发生率以及护理优良率。结果研究组肛门排气时间、输液时间、首次活动时间、住院时间短于对照组,住院费用少于对照组,差异均有统计学意义(P<0.05)。研究组干预后凝血酶原时间(PT)、D-二聚体、部分凝血活酶时间(APTT)、组织型纤溶酶原激活剂物抗原(tPA-Ag)低于对照组,组织型纤溶酶原激活物抑制物(PAI)高于对照组,差异均有统计学意义(P<0.05)。2组患者干预后的环境、生理情况、独立性状态、心理状态、精神支持、社会关系评分及总分均较干预前提高,且研究组患者干预后的环境、生理情况、独立性状态、心理状态、精神支持、社会关系评分及总分高于对照组患者,差异均有统计学意义(P<0.05)。研究组患者干预后下肢肿胀或者疼痛、下肢静脉血栓、肺栓塞等并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组患者护理优良率为97.83%,高于对照组的67.65%,差异有统计学意义(P<0.05)。结论基于层次分析法的护理干预可以有效缩短肾肿瘤切除术患者的康复时间,提高患者生活质量,预防下肢静脉血栓形成。

Objective To observe the effect of nursing intervention based on analytic hierarchy process in prevention of phlebothrombosis of lower limbs after renal tumor resection.Methods Clinical materials of 80 patients with renal tumor resection from October 2017 to October 2019 were analyzed retrospectively.According to the application time of nursing intervention based on analytic hierarchy process,the patients treated with routine nursing intervention from October 2017 to September 2018 were selected as control group(n=34),and the patients treated with nursing intervention based on analytic hierarchy process from October 2018 to October 2019 were selected as study group(n=46).Rehabilitation related indexes,coagulation and fibrinolysis indexes after intervention,quality of life,incidence of complications and excellent rate of nursing were compared between the two groups.Results The time to anal exhaustion,infusion time,time to first activity and hospitalization time of the study group were significantly shorter than those of the control group,and the hospitalization expense was signifiantly less than that of the control group(P<0.05).After the intervention,prothrombin time(PT),D-dimer,partial thromboplastin time(APTT),plasma tissue plasminogen activator antigen(TPA-Ag)in the study group were significantly lower than those in the control group,and the tissue-type plasminogen activator inhibitor(PAI)was significantly higher than that in the control group(P<0.05).After intervention,the scores of environment,physiology,independence,psychological state,mental support,social relationship and total score in both groups increased significantly,and the scores of environment,physiological condition,independent state,psychological state,mental support,social relationship score and total score in the study group were significantly higher than those in the control group(P<0.05).The incidence rates of lower limbs swelling or pain,venous thrombosis of lower limbs,pulmonary embolism and other complications in the study group were significantly lower than those in the control group(P<0.05).The excellent rate of nursing in the study group was 97.83%,which was significantly higher than 67.65% in the control group(P<0.05).Conclusion Nursing intervention based on analytic hierarchy process can effectively shorten the recovery time of patients with renal tumor resection,improve the quality of life of patients,and prevent phlebothrombosis of lower limbs.