基于自我管理导向的5A护理模式对脑出血患者术后下肢深静脉血栓形成的预防效果

Preventive effect of self-management-oriented 5A nursing model on postoperative lower extremity deep vein thrombosis in patients with cerebral hemorrhage

目的分析基于自我管理导向的5A护理模式在预防脑出血患者术后下肢深静脉血栓形成方面的效果。方法选择2019年1月至2021年1月在河南中医药大学第一附属医院进行手术治疗的90例脑出血患者为研究对象。采用随机数字表法将患者分为对照组和观察组,每组45例。对照组患者接受常规护理干预,观察组患者接受基于自我管理导向的5A护理模式干预。比较2组患者护理干预前后下肢股静脉血流峰速度和平均流速、下肢深静脉血栓形成率和护理满意度、运动能力、自我护理效能和生活质量。结果干预前,2组患者的下肢股静脉血流峰速度和平均流速、Barthel和Fugl-Meyer评估(FMA)评分、自我护理效能和生活质量评分比较差异均无统计学意义(P>0.05)。2组患者干预后下肢股静脉血流峰速度和平均流速、Barthel和FMA评分、自我护理效能和生活质量评分均显著高于干预前(P<0.05)。干预后,观察组患者的下肢股静脉血流峰速度和平均流速、Barthel和FMA评分、自我护理效能和生活质量评分均显著高于对照组(P<0.05)。对照组和观察组患者下肢深静脉血栓形成率分别为28.57%(12/42)、2.22%(1/45),观察组患者下肢深静脉血栓形成率显著低于对照组(χ2=11.731,P<0.05)。对照组和观察组患者对护理的总满意率分别为71.43%(30/42)、93.33%(42/45),观察组患者的护理总满意率显著高于对照组(χ2=6.408,P<0.05)。结论基于自我管理导向的5A护理模式能有效预防脑出血患者术后下肢深静脉血栓的形成,同时还可改善患者的生活质量和自我护理效能,患者对护理的满意度较高。

Objective To investigate the effect of self-management-oriented 5A nursing model in preventing postoperative lower extremity deep vein thrombosis in patients with cerebral hemorrhage.Methods A total of 90 patients with cerebral hemorrhage who underwent operation treatment in the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to January 2021 were selected as the study subjects.The patients were divided into control group and observation group by random number table methods,with 45 patients in each group.The patients in control group received routine nursing intervention,the patients in the observation group received self-management-oriented 5A nursing intervention.The peak velocity and average velocity of femoral vein blood flow in lower limbs,lower extremity deep vein thrombosis rate,nursing satisfaction,exercise ability,self-care efficacy and quality of life were compared between the two groups.Results Before intervention,there was no significant difference in the peak velocity and average velocity of femoral vein blood flow,Barthel and Fugl-Meyer assessment(FMA)scores,self-care efficacy and quality of life scores of patients between the two groups(P>0.05).The peak velocity and average flow velocity of femoral vein blood flow,Barthel and FMA scores,self-care efficacy and quality of life scores of patients after intervention were significantly higher than those before intervention in the two groups(P<0.05).After intervention,the peak velocity and average flow velocity of femoral vein blood flow,Barthel and FMA scores,self-care efficacy and quality of life scores of patients in the observation group were significantly higher than those in the control group(P<0.05).The lower extremity deep vein thrombosis rate of the patients in the control group and the observation group was 28.57%(12/42)and 2.22%(1/45),respectively;the lower extremity deep vein thrombosis rate of patients in the observation group was significantly lower than that in the control group(χ^(2)=11.731,P<0.05).The total rate of satisfaction to nursing of patients in the control group and the observation group was 71.43%(30/42)and 93.33%(42/45),respectively;the total rate of satisfaction to nursing of patients in the observation group was significantly higher than that in the control group(χ^(2)=6.408,P<0.05).Conclusion The self-management-oriented 5A nursing model can effectively prevent the lower extremity deep vein thrombosis in patients with cerebral hemorrhage after operation,and it can also improve the quality of life,self-nursing efficacy of patients.