老年PFNA术后下肢DVT预测模型的建立及干预措施

Prediction model and intervening measures of lower extremity DVT after elderly PFNA surgery

目的:探讨基于logistics回归预测模型的多学科综合护理预防老年股骨近端防旋髓内钉(PFNA)术后下肢深静脉血栓(DVT)的效果。方法:基于logistics回归建立297例老年PFNA术后患者下肢DVT的风险预测模型。将138例老年PFNA术后患者随机分为干预组和对照组,并比较两组下肢DVT发生时间和发生率。结果:风险预测模型,P=1/1+e{[-(-2.136+0.472×(合并糖尿病))+0.596×(受伤至手术时间)+0.691×(既往静脉血栓栓塞症病史)+1.255×(术后无UAT)+0.813×(术后D-D)+0.704×(长期卧床)]};干预组下肢DVT发生时间长于对照组(P<0.05),发生率低于对照组(P<0.05)。结论:基于logistics回归预测模型的多学科综合护理可降低老年PFNA术后下肢DVT的发生率。

Objective:To explore the effect of multidisciplinary comprehensive nursing based on prediction model of logistics regression analysis on preventing lower extremity deep venous thrombosis(DVT)after proximal femoral nail antirotation(PFNA)in elderly patients.Methods:The risk prediction model of lower extremity DVT in 297 elderly patients after PFNA surgery was established based on logistic regression.138 elderly patients after PFNA surgery were randomly divided into intervention group and control group,and the occurrence time and incidence of lower extremity DVT were compared between the two groups.Results:The risk prediction model was shown as P=1/1+e{^([-(-2.136+0.472×(diabetes mellitus))+0.596×(time from injury to surgery)+0.691×(previous history of venous thromboembolism)+1.255×(absence of UAT after surgery)+0.813×(postoperative D-D)+0.704×(long-term bed rest)])}.The occurrence time of lower extremity DVT in intervention group was longer than that in control group(P<0.05),and the incidence rate was lower than that in control group(P<0.05).Conclusion:Multidisciplinary comprehensive nursing based on prediction model of logistics regression analysis can reduce the incidence rate of lower extremity DVT in the elderly after PFNA surgery.