普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识

Expert consensus on risk assessment and prevention of venous thromboembolism in general surgical patients

目的编写《普通外科患者静脉血栓栓塞症风险评估与预防护理专家共识》(以下简称《共识》),以期推动国内普通外科患者静脉血栓栓塞症的规范化管理。方法查阅国内外文献并对25名临床医疗和护理专家进行访谈,编写《共识》初稿,编制函询表,在全国范围内遴选专家召开2次专家现场论证会,并先后进行2轮专家函询,结合专家意见修改相应条目,评定证据等级和推荐等级,形成《共识》。结果通过专家函询,确立了4个一级主题和26个二级主题,函询问卷的有效回收率均为100%,专家判断依据系数为0.960,熟悉程度系数为0.912,权威程度系数为0.936;2轮专家函询一、二级主题的肯德尔和谐系数分别为0.149、0.261和0.122、0.203,差异均具有统计学意义(P<0.05)。《共识》包括普通外科患者静脉血栓栓塞症危险因素、风险评估、风险应对、培训与质量控制4个方面内容,适用于普通外科围手术期患者。结论《共识》融合了25名临床医疗和护理专家的建议,结果具有科学性、严谨性和权威性,可为临床护理人员开展普通外科患者静脉血栓栓塞症的防控工作提供指引。

Objective To explore the expert consensus on risk assessment and preventive nursing of venous thromboembolism(VTE)in general surgical patients.Methods This consensus was drafted through a systemic literature review on VTE prevention and the interviews of nursing experts.The draft was thereafter reviewed by a total of experts in related fields,and it was finalized after 2 rounds of expert consultation.Results 4 domains with 26 components were established through a modified Delphi method.The effective recovery of the ques-tionnaire was 100%;the expert judgment coefficient was 0.960;the familiarity was 0.912;the authority coefficient was 0.936.The Kendall coefficients of the first and second level topics in the 2 rounds were 0.149 and 0.261,and 0.122 and 0.203,respectively,with statistically significant differences(P<0.05).The consensus includes risk factors for VTE in general surgical patients,risk assessment,risk response,education and quality control,and it is applicable to perioperative patients of general surgery.Conclusion The consensus was based on the recommendations of 25 clinical nursing experts.The results are scientific,rigorous and authoritative,and can provide guidance for clinical nursing staff in the prevention and control of VTE in general surgical patients.