基于Caprini风险评估模型的护理干预对骨科大手术静脉血栓栓塞症的预防效果

Effect of Caprini risk score-based care on the prevention of venous thromboembolism of patients with major orthopedic surgery

目的探讨基于Caprini风险评估模型的护理干预对骨科大手术静脉血栓栓塞症(VTE)的预防效果。方法将124例拟行骨科大手术患者按照随机数字表分为试验组和对照组各62例。对照组给予常规护理,试验组采用基于Caprini风险评估模型的护理干预。比较2组患者VTE发生率,分别于入院当日、术后3、5 d和出院当日测量患者D-二聚体值和患肢周径;出院时向患者发放住院患者护理工作满意度量表评价患者对护理工作的满意度。结果试验组VTE发生率为1.6%(1/62),对照组为6.5%(4/62),2组差异无统计学意义(χ^(2)值为1.876,P=0.171)。术后3、5 d和出院当日试验组D-二聚体值为(1.26±0.65)、(1.27±0.35)、(0.96±0.27)mg/L,术后5 d、出院当日试验组患肢周径为(29.81±4.15)、(28.86±3.40)cm,明显低于对照组的(1.64±0.58)mg/L、(1.51±0.55)mg/L、(1.25±0.44)mg/L、(31.84±5.22)cm、(30.83±3.91)cm,差异有统计学意义(t值为2.405~4.485,P<0.05)。试验组健康教育及指导、个人特质与服务态度、服务质量、出院指导等维度得分和护理工作满意度总分为(26.31±3.06)、(35.73±3.64)、(27.89±3.11)、(8.47±1.18)分和(111.08±6.33)分,明显高于对照组的(24.15±2.31)、(33.92±2.66)、(26.27±3.41)、(7.42±1.82)分和(106.52±5.85)分,差异有统计学意义(t值为2.750~4.433,P<0.05)。结论基于Caprini风险评估模型的护理干预可以改善骨科大手术患者的凝血功能和患肢肿胀程度,提高患者对护理工作的满意度,值得临床推广。

Objective To investigate the effect of Caprini risk score-based care on the prevention of venous thromboembolism of patients with major orthopedic surgery.Methods Totally 124 patients with major orthopedic surgery were randomly divided into experimental group and control group,each group contained 62 cases.The control group received routine thrombosis prevention nursing,patients in the experimental group carried out Caprini risk score-based intervention.The rate of VTE was compared between two groups,the levels of D-Dimer as well as thigh circumference was measured after 24 hours of admission,3 days after surgery,5 days after surgery and at discharge day.At discharge day,the inpatients satisfaction with nursing service scale was used to assessment the satisfaction with nursing service of inpatients.Results The rate of VTE in the experimental group was 1.6%(1/62)and 6.5%(4/62)in the control group,the difference was not statistically significant(χ^(2)value was 1.876,P=0.171).Three days after surgery,5 days after surgery and at discharge day,the D-Dimer were(1.26±0.65)μg/ml,(1.27±0.35)μg/ml,(0.96±0.27)μg/ml in the experimental group,5 days after surgery and at discharge day,the thigh circumference were(29.81±4.15)cm,(28.86±3.40)cm in the experimental group,significantly lower than those in the control group[(1.64±0.58)μg/ml,(1.51±0.55)μg/ml,(1.25±0.44)μg/ml,(31.84±5.22)cm,(30.83±3.91)cm],the difference was statistically significant(t value was 2.405-4.485,P<0.05).The health education and guidance,personality traits,service quality,discharge guidance scores and total satisfaction scores were 26.31±3.06,35.73±3.64,27.89±3.11,8.47±1.18 and 111.08±6.33,significantly higher than those in the control group(24.15±2.31,33.92±2.66,26.27±3.41,7.42±1.82 and 106.52±5.85),the difference was statistically significant(t value was 2.750-4.433,P<0.05).Conclusions Caprini risk score-based nursing care significantly alleviates the hypercoagulable states and relieves the degree of swelling of the affected of patients with major orthopedic surgery,as well as improves patients'satisfaction with nursing work.