基于ERAS理念的DVT预防方案在子宫肌瘤切除术患者护理中的应用效果

Effect of ERAS concept-based DVT prevention in the care of patients undergoing myomectomy

目的 探讨基于加速康复外科(ERAS)理念的深静脉血栓(DVT)预防方案在子宫肌瘤切除术患者护理中的临床应用价值,以期为临床相关治疗提供参考。方法 选取2020年1月—2021年1月盘锦辽油宝石花医院收治的80例接受手术治疗的子宫肌瘤患者为研究对象。采用随机数字表法将患者分为研究组(40例)与对照组(40例)。对照组患者自确诊当天起接受为期2周的常规护理干预。研究组患者接受为期2周的基于ERAS理念的DVT预防方案干预。比较2组患者干预前后(干预后为出院时)抑郁自评量表(SDS)与焦虑自评量表(SAS)评分及血栓弹力图(TEG)参数(R值、K值、α角)。比较2组患者出院时纽卡斯尔护理满意度调查量表(NSNS)评分。比较出院3个月内2组患者DVT发生率。结果 干预前,2组患者SDS及SAS评分比较,差异无统计学意义(P>0.05)。干预后,2组患者SDS及SAS评分均低于干预前,且研究组低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者α角、R值及K值比较,差异无统计学意义(P>0.05)。干预后,2组患者α角小于干预前,且研究组小于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者R值、K值大于干预前,且研究组大于对照组,差异均有统计学意义(P<0.05)。研究组患者护理总满意度为97.5%,高于对照组的80.00%,差异有统计学意义(P<0.05)。研究组患者发生DVT 1例(2.50%),对照组发生DVT 8例(20.00%)。研究组患者DVT发生率低于对照组,差异有统计学意义(P<0.05)。结论 基于ERAS理念的DVT预防方案在子宫肌瘤切除术患者护理中的应用效果确切,可减轻患者负性情绪,改善患者血液动力学指标,降低术后DVT形成风险,该护理方案可操作性强,临床应用前景广阔。

Objective To investigate the clinical value of deep venous thrombosis(DVT) prevention based on the concept of enhanced recovery after surgery(ERAS) in the care of patients undergoing myomectomy,in order to provide a reference for clinical treatment.Methods Eighty patients with uterine fibroids who underwent surgical treatment in Panjin Liaohe Oilfield Gem Flower Hospital from January 2020 to January 2021 were selected as the study participants.The patients were assigned to the experimental group(n=40) and control group(n=40) by random number table.Patients in the control group received routine care intervention for 2 weeks from the day of diagnosis.Patients in the experimental group received a 2-week ERAS concept-based DVT prevention intervention.Self-rating depression scale(SDS),self-rating anxiety scale(SAS) scores,and thrombelastogram(TEG) parameters(R value,K value,α angle) were compared between the two groups before and after intervention(discharge).Newcastle Satisfaction with Nursing Scale(NSNS) scores at discharge were compared between the 2 groups.The incidence of DVT was compared between the 2 groups within 3 months after discharge.Results Before the intervention,there was no significant difference in SDS and SAS scores between the two groups(P>0.05).After the intervention,SDS and SAS scores in the two groups were lower than those before the intervention,with the experimental group lower than the control group,and the differences were statistically significant(P<0.05).Before the intervention,there was no significant difference in α angle,R and K values between the two groups(P>0.05).After the intervention,the α angle in the 2 groups was smaller than that before the intervention,with the experimental group smaller than the control group,and the differences were statistically significant(P<0.05).After the intervention;the R and K values of patients in the 2 groups were greater than those before the intervention,with the experimental group greater than the control group,all with statistically significant differences(P<0.05).The total satisfaction rate of care in the experimental group was 97.5%,which was higher than that in the control group(80.00%),with a statistically significant difference(P<0.05).DVT occurred in 1 patient(2.50%) in the experimental group and 8 patients(20.00%) in the control group.The incidence rate of DVT in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion ERAS concept-based DVT prevention is effective in the care of patients undergoing myomectomy,which can reduce negative emotions,improve hemodynamic parameters and reduce the risk of postoperative DVT.This care protocol has strong operability and holds substantial promise for clinical application.