护医检一体化模式对子宫内膜癌患者术后下肢静脉血栓的预防效果

Preventive effect of the integrated model of nursing-doctor and clinical laboratory on postoperative lower limb venous thrombosis in patients with endometrial cancer

目的探讨护医检一体化模式对子宫内膜癌患者术后下肢静脉血栓的预防效果。方法选择2020年1月~2021年5月在哈尔滨医科大学附属第一医院妇科接受子宫内膜癌广泛性子宫切除术的患者76例,随机分为两组:观察组38例,研究组38例;观察组实施常规干预,研究组在实施常规干预的基础上采取护医检一体化模式,对比两组患者术前与术后的大腿腿围、小腿腿围、凝血象、D-D聚体的变化情况,以及两组患者的下肢静脉血栓发生率。结果观察组有4例患者出现下肢静脉血栓的情况,发生率为10.5%,研究组未发生下肢静脉血栓,发生率为0.00%,差异有统计学意义(P<0.05)。两组患者在术前1日与术后1日的腿围比较差异无统计学意义(P>0.05),在术后3日研究组患者的大腿腿围与小腿腿围的平均值均小于观察组,差异有统计学意义(P<0.05);在术后7日两组患者的腿围均恢复到术前的情况,差异无统计学意义(P>0.05)。术前两组患者的凝血象指标的水平差异均无统计学意义(P>0.05),术后仅有研究组的D-D聚体含量低于观察组,差异有统计学意义(P<0.05),其他凝血象指标的水平差异无统计学意义(P>0.05)。结论护医检一体化模式对子宫内膜癌患者术后预防下肢静脉血栓有较好的效果。

Objective To explore preventive effect of the integrated model of nursing-doctor and clinical laboratory on postoperative lower limb venous thrombosis in patients with endometrial cancer.Methods Seventy-six patients underwent extensive hysterectomy for endometrial cancer in the gynecological ward of the First Affiliated Hospital of Harbin Medical University from January 2020 to May 2021 were collected,they were randomly divided into two groups,both groups were consisted of 38 cases.The observation group performed the routine intervention,and the research group performed the integrated model of nursing-doctor and clinical laboratory based on the implementation of routine intervention.The changes of thigh and leg circumference,calf and leg circumference,coagulation,D-dimer and the incidence of lower limb venous thrombosis were compared between the two groups.Results Four patients in the observation group developed deep venous thrombosis of lower limbs and the incidence rate was 10.5%.No deep venous thrombosis of lower limbs occurred in the reseach group,the incidence rate was 0.00%,and the difference was statistically significant(P<0.05).There was no significant difference in the leg circumference between the first day before surgery and the first day after surgery in the two groups(P>0.05).In the third day after surgery,the average of the thigh and lower leg circumference in the research group was smaller than that in the observation group,the difference was statistically significant(P<0.05).In the seventh day after surgery,leg circumference returned to preoperative conditions in both groups,there was no significant difference(P>0.05).There was no significant difference between the both groups in the level of coagulation index before the surgery(P>0.05).The D-dimer of the research group was lower than that of the observation group(P<0.05),but other indexes were not significantly different(P>0.05).Conclusion The integrated model of nursing-doctor and clinical laboratory has a better effect on the postoperative prevention of deep venous thrombosis of lower limbs in patients with endometrial cancer.