孕期营养与认知干预对重度子痫前期患者剖宫产术后下肢深静脉血栓风险的影响

Effect of nutritional combined with cognitive intervention during pregnancy on risk of lower extremity deep vein thrombosis after cesarean section in patients with severe preeclampsia

目的探讨孕期营养干预结合认知干预对重度子痫前期患者剖宫产术后下肢深静脉血栓风险的影响。方法采用前瞻性研究。选取2020年5月至2022年1月郑州市妇幼保健院收治的重度子痫前期患者112例,随机数字表法分为干预组和常规组。常规组56例,年龄(26.91±2.13)岁,孕周(39.31±3.12)周,给予传统护理措施;干预组56例,年龄(26.94±2.07)岁,孕周(38.89±2.99)周,实施孕期营养干预结合认知干预。比较两组患者下肢肿胀、疼痛和深静脉血栓发生率、患者护理满意度、干预前后凝血功能指标和下肢静脉血流速度。采用χ^(2)、t检验进行统计学分析。结果干预组患者下肢肿胀[3.57%(2/56)]、下肢疼痛[5.36%(3/56)]和下肢深静脉血栓发生率[5.36%(3/56)]均明显低于常规组[16.07%(9/56)、25.00%(14/56)、19.64%(11/56)],差异均有统计学意义(χ^(2)=4.940、8.391、5.224,均P<0.05)。干预后,干预组患者凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)高于常规组,纤维蛋白原(FIB)低于常规组(均P<0.05)。干预后,干预组患者腘静脉和股静脉血流速度高于常规组,差异均有统计学意义(均P<0.05)。干预组患者专业护理、自护指导、信息支持和病情观察等护理满意度评分明显高于常规组,差异均有统计学意义(均P<0.05)。结论孕期营养干预结合认知干预可降低重度子痫前期患者剖宫产术后下肢深静脉血栓的发生风险,改善产妇凝血功能,提高下肢静脉血流速度,产妇满意度较高,值得进一步推广应用。

Objective To explore the effect of nutritional intervention combined with cognitive intervention during pregnancy on the risk of lower extremity deep vein thrombosis after cesarean section in patients with severe preeclampsia.Methods This was a prospective study.A total of 112 patients with severe preeclampsia admitted to Zhengzhou Maternal and Child Health Hospital from May 2020 to January 2022 were selected and divided into an intervention group and a conventional group by the random number table method,with 56 cases in each group.The conventional group were(26.91±2.13)years old,with a gestational age of(39.31±3.12)weeks.The intervention group were(26.94±2.07)years old,with a gestational age of(38.89±2.99)weeks.The conventional group were given traditional nursing measures, while the intervention group weregiven pregnancy nutrition intervention and cognitive intervention. The incidences of lowerextremity swelling, pain, and deep vein thrombosis, nursing satisfaction, and coagulation functionindicators and lower extremity venous blood flow velocities before and after the intervention werecompared between the two groups. χ^(2) and t tests were applied. Results The incidences of lowerlimb swelling, pain, and deep vein thrombosis in the intervention group were significantly lowerthan those in the conventional group [3.57% (2/56) vs. 16.07% (9/56), 5.36% (3/56) vs. 25.00%(14/56), and 5.36% (3/56) vs. 19.64% (11/56)], with statistical differences (χ^(2)=4.940, 8.391, and5.224;all P<0.05). After the intervention, prothrombin time (PT), thrombin time (TT), and activatedpartial thromboplastin time (APTT) in the intervention group were longer than those in theconventional group, and the fibrinogen (FIB) level was lower than that in the conventional group (allP<0.05). After the intervention, the blood flow velocities of popliteal and femoral veins in theintervention group were higher than those in the conventional group, with statistical differences(both P<0.05). The nursing satisfaction scores of professional nursing, self-care guidance,information support, and condition observation in the intervention group were significantly higherthan those in the conventional group, with statistical differences (all P<0.05). Conclusion Nutritional intervention combined with cognitive intervention during pregnancy can reduce the riskof lower extremity deep vein thrombosis in patients with severe preeclampsia after cesarean sectionand improve their coagulation function, lower extremity venous blood flow velocity, and satisfaction,so it is worthy of further promotion and application.