神经内科ICU老年患者下肢DVT的护理对策及对睡眠的影响探讨

Nursing Strategy and Effect on Sleep of Senile Patients with Lower Extremity DVT in Neurology ICU

目的:研究神经内科ICU老年患者下肢DVT的临床特点与护理对策。方法:选取2019年8月至2020年3月福建医科大学附属第一医院神经内科ICU收治的老年患者22例作为研究对象,实施预见性护理,比较护理前后满意度、睡眠质量。根据DVT发生情况及VTE评分分为非DVT组(n=20)和DVT组(n=2),比较2组临床资料,分析临床特点。结果:DVT组平均年龄(69.5±1.50)岁,FIB(476.03±25.74)mg/dL,D-D(229.35±18.52)μg/L,卧床时间(13.5±0.50)d。均使用抗生素、有高血压病史、糖尿病病史、心脏病病史、有静脉置管。2组比较,差异有统计学意义(P<0.05)。结论:神经内科ICU老年患者发生下肢DVT多同时存在高血压、心脏病、糖尿病、静脉置管、使用抗生素、住院时间长,FIB和D-D二聚体指标升高等临床特点,多发生肌间静脉血栓。因此需要根据患者临床资料,密切监护下肢DVT的发生,及早进行预防护理干预,可有效控制下肢DVT发病率,保护患者生命安全,为患者康复和治疗创造良好的条件。

Objective:To study the clinical characteristics and nursing strategies of senile patients with lower extremity DVT in neurology ICU.Methods:A total of 22 cases of elderly patients admitted to the ICU of Department of Neurology,the First Affiliated Hospital of Fujian Medical University were randomly selected as the research object,and the satisfaction and sleep quality were compared before and after the implementation of predictive nursing.According to the occurrence of DVT and VTE score,the patients were divided into non-DVT group(n=20)and DVT group(n=2).The clinical data of the two groups were compared and the clinical characteristics were analyzed.Results:The mean age of DVT group was(69.5±1.50)years old,FIB was(476.03±25.74)mg/dL,D-D was(229.35±18.52)μg/L,and bed time was(13.5±0.50)D.All patients took antibiotics,had a history of hypertension,diabetes,heart disease,and had intravenous catheterization.The difference between the two groups was statistically significant(P<0.05).Conclusion:The elderly ICU patients with lower extremity DVT in Department of Neurology often have clinical characteristics such as hypertension,heart disease,diabetes,intravenous catheterization,antibiotic use,long hospital stay,increased FIB and D-D dimer indexes,and often have intermuscular vein thrombosis.Therefore,it is necessary to closely monitor the occurrence of lower limb DVT according to the clinical data of patients,and carry out preventive nursing intervention as early as possible,which can effectively control the incidence of lower limb DVT,protect the life safety of patients,and create good conditions for the rehabilitation and treatment of patients.