分级监控管理理念在神经外科手术患者术后静脉血栓栓塞中的预防效果

Effect of graded monitoring management concept on the prevention of postoperative venous thromboembolism in neurosurgical patients

目的 探讨分级监控管理理念在神经外科手术患者术后静脉血栓栓塞(VTE)中的预防效果。方法 回顾性分析2020年1月至2022年6月在南京鼓楼医院集团宿迁医院行神经外科手术治疗的86例患者的一般资料,根据护理方法的不同将其分为对照组(42例)和观察组(44例)。对照组予以常规护理,观察组在其基础上增加分级监控管理理念干预。比较2组患者在术后的VTE发生情况,以及护理前后的血流速度、血液流变学指标和凝血功能。结果 护理2周后,观察组的股静脉和腘静脉血流速度均较对照组快,血浆黏度、红细胞沉降率、红细胞聚集指数、D-二聚体和纤维蛋白原水平均较对照组低(P<0.05),凝血酶原时间和活化部分凝血活酶时间均较对照组长(P均<0.05);2组患者的上述指标均较护理前有所改善(P均<0.05)。观察组的术后VTE发生率低于对照组(P<0.05)。结论 分级监控管理理念干预可明显改善行神经外科手术患者的凝血功能、血流速度及血液流变学指标,并降低术后VTE发生率。

Objective To explore the effect of the concept of graded monitoring management on the prevention of postoperative venous thromboembolism(VTE)in the neurosurgical patients.Methods The general data of 86 patients who underwent neurosurgery at Nanjing Drum Tower Hospital Group,Suqian Hospital from January 2020 to June 2022 were retrospectively analyzed.They were assigned into a control group(42 cases)and an observation group(44 cases)according to different nursing methods.The control group was given routine nursing,and the observation group was additionally given intervention of graded monitoring management concept.The postoperative VTE,blood flow velocity,hemorheological parameters,and coagulation function before and after nursing were compared between the two groups.Results After 2 weeks of nursing,the blood flow velocity of femoral vein and popliteal vein in the observation group was faster than that in the control group.The plasma viscosity,erythrocyte sedimentation rate,erythrocyte aggregation index,D-dimer,and fibrinogen were lower than those in the control group.The prothrombin time and activated partial thromboplastin time were longer than those in the control group(all P<0.05).The above parameters in both groups were improved compared with those before nursing(all P<0.05).The incidence of postoperative VTE in the observation group was lower than that in the control group(P<0.05).Conclusion The intervention of graded monitoring management concept can significantly improve the coagulation function,blood flow velocity,and hemorheological parameters of neurosurgical patients,and reduce the incidence of postoperative VTE.