基于Caprini深静脉血栓形成风险评估表的预防性护理干预在重症脑出血术后昏迷患者中的应用

Application of preventive care intervention based on Caprini Deep Venous Thrombosis Risk Assessment Form in patients with coma after severe cerebral hemorrhage surgery

目的 探讨基于Caprini深静脉血栓形成风险评估表的预防性护理干预在重症脑出血术后昏迷患者中的应用效果,以期为临床治疗提供参考。方法 选取2019年4月—2021年3月平顶山市第一人民医院收治的87例重症脑出血术后昏迷患者为研究对象。采用随机数字表法将患者分为研究组(n=44)与常规组(n=43)。常规组患者实施常规护理,研究组患者在常规组护理基础上实施基于Caprini深静脉血栓形成风险评估表的预防性护理干预。比较2组患者住院期间下肢深静脉血栓形成(LEDVT)发生率。比较2组干预前后(干预后为出院时)下肢股静脉血流速度、峰流速、血流量及格拉斯昏迷评分量表(GCS)评分、纤维原蛋白(FIB)水平、活化部分凝血酶时间(APTT)。比较2组患者ICU入住时间及住院时间。结果 研究组患者LEDVT发生率2.27%低于常规组的18.60%,差异有统计学意义(P<0.05)。干预前,2组患者血流速度、峰流速及血流量比较,差异无统计学意义(P>0.05)。干预后,2组患者血流速度、峰流速均快于干预前,且研究组快于对照组,差异均有统计学意义(P<0.05);2组患者血流量多于干预前,且研究组多于对照组,差异有统计学意义(P<0.05)。研究组患者入住ICU时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。干预前,2组患者APTT及FIB水平比较,差异无统计学意义(P>0.05)。干预后,2组患者APTT长于干预前,研究组长于对照组,差异有统计学意义(P<0.05);2组患者FIB水平低于干预前,研究组低于常规组,差异有统计学意义(P<0.05)。干预前,2组患者GCS评分比较,差异无统计学意义(P>0.05)。干预后,2组患者GCS评分均高于干预前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论 基于Caprini深静脉血栓形成风险评估表的预防性护理干预应用于重症脑出血术后昏迷患者护理中,可有效预防LEDVT的发生,促进患者血流动力学及凝血指标改善,缩短住院时间,对促进患者意识恢复有积极作用。

Objective To explore the effectiveness of preventive care intervention based on the Caprini Deep Venous Thrombosis Risk Assessment Form in patients with coma after severe intracerebral hemorrhage surgery,so as to provide support for clinical treatment.Methods Eighty-seven patients with coma after severe intracerebral hemorrhage surgery admitted to the First People’s Hospital of Pingdingshan from April 2019 to March 2021 were selected as the study participants.They were assigned to the experimental group(n=44) and conventional group(n=43) by random number table.Patients in the conventional group received routine care and patients in the experimental group;preventive care interventions based on the Caprini Deep Vein Thrombosis Risk Assessment Form in addition to routine care.The incidence of lower extremity deep venous thrombosis(LEDVT) during hospitalization was compared between the 2 groups.Blood flow velocity,peak flow velocity,blood flow,Glasgow Coma Scale(GCS) score,fibrinogen(FIB) level,and activated partial thrombin time(APTT)were compared between the two groups before and after intervention(after intervention as discharge).Length of ICU stay and hospital stay were compared between the 2 groups.Results The incidence of LEDVT in the experimental group was 2.27%,which was significantly lower than that(18.60%) in the conventional group(P<0.05).Before the intervention,there was no significant difference in blood flow velocity,peak flow velocity,and blood flow between the two groups(P>0.05).After the intervention,the blood flow velocity and peak flow velocity in the two groups were significantly faster than those before the intervention,with the experimental group faster than the control group(P<0.05).The blood flow in the two groups was significantly larger than that before the intervention,with the experimental group larger than the control group(P<0.05).The ICU admission time and length of hospital stay in the experimental group were significantly longer than those in the control group(P<0.05).Before the intervention,there was no significant difference in APTT and FIB levels between the two groups(P>0.05).After the intervention,APTT in the two groups was significantly longer than that before the intervention,with the experimental group significantly shorter than the control group(P<0.05);FIB level in the two groups was significantly lower than that before the intervention,with the experimental group significantly lower than the conventional group(P<0.05).Before the intervention,there was no significant difference in GCS scores between the two groups(P>0.05).After the intervention,the GCS scores of patients in both groups were significantly higher than those before the intervention,and the experimental group was higher than the control group(P<0.05).Conclusion Preventive care intervention based on Caprini Deep Venous Thrombosis Risk Assessment Form can effectively prevent the occurrence of LEDVT,improve hemodynamics and coagulation parameters,and shorten the length of hospital stay,which plays a positive role in promoting the recovery of consciousness in patients with coma after severe intracerebral hemorrhage surgery.