多学科联合质量改进方案在急性缺血性脑卒中患者深静脉血栓中的防控效果

Effect of multidisciplinary quality improvement program on prevention andcontrol of deep vein thrombosis in patients with acute ischemic stroke

目的:分析多学科联合质量改进方案在急性缺血性脑卒中患者深静脉血栓(Deep venous thrombosis,DVT)中的防控效果。方法:选取2020年6月至2022年6月期间我院收治的158例急性缺血性脑卒中患者作为研究对象,将其依据简单随机法分为对照组和观察组,各79例。对照组患者采取常规DVT防控干预,观察组患者采取多学科联合质量改进方案DVT防控干预。对两组干预前后的凝血功能指标水平、平均血流速度、DVT健康信念评分进行比较,并比较两组干预后的DVT情况和并发症情况。结果:干预后,两组的血小板(Platelet,PLT)、纤维蛋白原(Fibrinogen,FIB)水平均降低,且观察组低于对照组;两组的活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、凝血酶原时间(Prothrombin time,PT)、凝血酶时间(Thrombin time,TT)、股静脉和腘静脉平均血流速度、各项DVT健康信念评分均升高,且观察组明显高于对照组(P<0.05)。干预后,观察组消化道溃疡、恶心/呕吐、腹泻、头痛/头晕的总发生率明显低于对照组(P<0.05)。结论:急性缺血性脑卒中患者经多学科联合质量改进方案干预能够改善凝血功能和血流速度,降低DVT和并发症的发生率,具有一定的DVT防控价值。

Objective:To analyze the effect of multidisciplinary combined quality improvement program on the prevention and control of deep vein thrombosis(DVT)in patients with acute ischemic stroke.Methods:A total of 158 patients with acute ischemic stroke treated in our hospital from June 2020 to June 2022 were selected as the research objects and divided into two groups according to the simple random method,with 79 cases in each group.Patients in the control group were given conventional DVT prevention and control intervention,while patients in the observation group were given DVT prevention and control intervention with multidisciplinary combined quality improvement scheme.The coagulation function index level,mean blood flow velocity,DVT health belief score before and after intervention were compared between the two groups,and DVT and complications were compared between the two groups after intervention.Results:After the intervention,the levels of Platelet(PLT)and Fibrinogen(FIB)were decreased compared with those before the intervention.After intervention,the Activated partial thromboplastin time(APTT)and Prothrombin time(Prothrombin time)of the observation group were lower than those of the control group.PT,Thrombin time(TT),femoral vein and popliteal vein mean blood flow velocity,and DVT health belief scores were increased,and the observation group was higher than the control group,and the differences were significant(P<0.05).After intervention,the total incidence of gastrointestinal ulcer,nausea/vomiting,diarrhea,headache/dizziness in the observation group was 5.07%,which was lower than 15.19%in the control group,and the difference was significant(P<0.05).Conclusion:The intervention of multidisciplinary quality improvement program in patients with acute ischemic stroke can improve coagulation function and blood flow velocity,reduce the incidence of DVT and complications,and has certain value in the prevention and control of DVT.