护理专案管理在降低腹腔镜阑尾切除术后下肢深静脉血栓形成中的作用

Role of Nursing Project Management in Reducing Deep Vein Thrombosis of Lower Extremity After Laparoscopic Appendectomy

目的探讨护理专案管理在降低腹腔镜阑尾切除术后下肢深静脉血栓形成(DVT)中的作用。方法选取2020年1月至2021年1月在南阳市中心医院接受腹腔镜阑尾切除的80例阑尾炎患者为研究对象。依据随机数表法分为试验组和对照组,两组均为40例。对照组接受常规护理,试验组接受护理专案管理。比较两组凝血功能相关指标、不同时点D-二聚体(D-D)水平,以及并发症发生情况。结果干预前,两组凝血功能指标相比,差异无统计学意义(P>0.05);干预后试验组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)水平高于对照组,纤维蛋白原(Fib)水平低于对照组(P<0.05)。术前,两组D-D水平差异无统计学意义(P>0.05);术后3、5、9 d试验组D-D水平不断上升且高于对照组(P<0.05)。试验组并发症总发生率低于对照组(10.0%比32.5%,P<0.05),下肢DVT发生率低于对照组(5.0%比25.0%,P<0.05)。结论在腹腔镜阑尾切除术围手术期进行护理专案管理,可有效改善患者凝血功能,降低下肢DVT发生率。

Objective To explore the effect of nursing project management in reducing deep vein thrombosis(DVT)of lower extremity after laparoscopic appendectomy.Methods A total of 80 patients with appendicitis who underwent laparoscopic appendectomy in Nanyang Central Hospital from January 2020 to January 2021 were selected as the research subjects.According to the random number table method,they were divided into experimental group and control group,with 40 cases in both groups.The control group received routine nursing,and the experimental group received nursing project management.The coagulation function-related indexes,D-dimer(D-D)levels at different time points,and the occurrence of complications were compared between the two groups.Results Before the intervention,there was no statistical difference in coagulation function indexes between the two groups(P>0.05).After intervention,the levels of prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)in the experimental group were higher than those in the control group,and the level of fibrinogen(Fib)was lower than that in the control group(P<0.05).Before surgery,there was no statistical difference in D-D levels between the two groups(P>0.05).The D-D level in the experimental group increased continuously 3,5,and 9 days after operation and was higher than that in the control group(P<0.05).The total incidence of complications in the experimental group was lower than that in the control group(10.0%vs.32.5%,P<0.05).The incidence of lower extremity DVT in the experimental group was lower than that in the control group(5.0%vs.25.0%,P<0.05).Conclusion Nursing project management during the perioperative period of laparoscopic appendectomy could effectively improve the coagulation function of patients and reduce the incidence of lower extremity DVT.