围手术期预见性护理模式对全髋关节置换术患者下肢深静脉血栓形成的影响研究

Effect of Perioperative Predictive Nursing Mode on Deep Venous Thrombosis of Lower Extremity in Patients Undergoing Total Hip Replacement

目的:探讨全髋关节置换术(THR)患者行围手术期预见性护理干预对下肢深静脉血栓形成(DVT)的预防效果。方法:选取2020年6月—2021年12月北京丰台医院收治的68例THR患者,依据随机数表法分两组,各34例。对照组给予常规干预,观察组给予围手术期预见性护理干预。比较两组下肢DVT发生率、凝血功能、血小板计数、下肢静脉血流速度和髋关节功能。结果:观察组干预后下肢DVT发生率为2.94%,明显低于对照组的17.65%,差异有统计学意义(P<0.05);干预后,两组凝血酶原时间(PT)、活化部分凝血酶(APTT)较干预前均缩短,纤维蛋白原(FIB)、D-二聚体(D-D)较干预前均降低,且对照组PT、APTT均短于观察组,FIB、D-D均低于观察组,差异有统计学意义(P<0.05);观察组干预后下肢静脉血流速度、Harris评分高于对照组,差异有统计学意义(P<0.05)。结论:THR患者给予围手术期预见性护理干预,可有效改善凝血功能,避免术后下肢DVT发生,髋关节功能改善明显,下肢静脉血流动力学明显提升,利于下肢血液循环,提升术后康复效果。

Objective:To investigate the preventive effect of perioperative predictive nursing intervention on deep venous thrombosis(DVT)of lower extremity in patients with total hip replacement(THR).Method:A total of 68 patients with THR who admitted to Beijing Fengtai Hospital from June 2020 to December 2021 were selected and divided into two groups according to random number table method,34 cases in each group.The control group was given routine intervention and the observation group was given perioperative predictive nursing intervention.The incidence of DVT of lower extremity,coagulation function,platelet count,lower limb venous flow velocity and hip joint function were compared between two groups.Result:The incidence of DVT of lower extremity in the observation group was 2.94%,which was lower than 17.65%in the control group,the difference was statistically significant(P<0.05);after intervention,the prothrombin time(PT)and activated partial thromboplastin(APTT)of two groups were shortened compared with those before intervention,while the fibrinogen(FIB)and D-dimer(D-D)were both reduced compared with those before intervention,the PT and APTT of the control group were shorter than those of the observation group,and FIB and D-D were lower than those of the observation group,the differences were statistically significant(P<0.05);the blood flow velocity and Harris score of lower limb veins in the observation group after intervention were higher than thos e in the control group,the differences were statistically significant(P<0.05).Conclusion:Perioperative predictive nursing intervention for patients with THR can effectively improve the coagulation function,avoid the occurrence of postoperative DVT of lower extremity,significantly improve hip function,significantly increase the venous blood flow dynamics of lower limb,conducive to lower limb blood circulation,improve the postoperative rehabilitation effect.