基于品管圈的术后护理对下肢骨折术后下肢深静脉血栓的预防作用

Preventive effect of postoperative nursing based on quality control circle on deep venous thrombosis of lower limbs after lower limb fracture surgery

目的探究基于品管圈(QCC)的术后护理对下肢骨折术后下肢深静脉血栓(DVT)的预防作用。方法选取2021年1月至2022年3月安徽省安庆市第一人民医院接受手术治疗的下肢骨折患者90例,按照随机数字表法将其分为对照组和观察组,各45例。对照组给予常规围手术期护理干预,观察组采用基于QCC的术后护理干预。比较两组术后DVT、Homan征、Neuhof征的发生率,术后股静脉、腘静脉的血液流速情况及两组患者对护理人员的综合素质评估结果。结果观察组在术后DVT及Homan征、Neuhof征发生率均明显低于对照组,差异有统计学意义(P<0.05)。整体分析发现,两组股静脉、腘静脉血流速度组间、时间点和交互作用比较,差异有统计学意义(P<0.05)。组内比较:两组术后1、7、14 d的股静脉、腘静脉血流速度比较,差异有统计学意义(P<0.05);组间比较:观察组在术后7、14 d的股静脉、腘静脉血流速度均明显高于对照组,差异有统计学意义(P<0.05)。干预后,观察组护理人员的解决问题能力、沟通协调能力、工作积极性、团队意识及责任心评分均明显高于对照组,差异有统计学意义(P<0.05)。结论基于QCC的术后护理能显著降低下肢骨折患者术后DVT的发生率,提高护理人员的综合素质。

Objective To research the preventive effect of postoperative nursing based on quality control circle(QCC)on lower limb deep vein thrombosis(DVT)after lower limb fracture operation.Methods A total of 90 patients with lower limb fracture who received surgical treatment in Anqing First People’s Hospital,Anhui Province from January 2021 to March 2022 were selected,according to random number table method,the patients were divided into control group and observation group,with 45 cases in each group.The control group received conventional perioperative nursing intervention,and the observation group received postoperative nursing intervention based on QCC.The incidence of postoperative DVT,Homan sign and Neuhof sign,postoperative femoral vein and popliteal vein blood flow rate,and the comprehensive quality assessment results of the two groups of patients to the nursing staff were compared.Results The incidence of postoperative DVT,Homan sign,and Neuhof sign in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).Overall analysis found that there were statistically significant differences in blood flow velocity,time point,and interaction between the two groups of femoral vein and popliteal vein(P<0.05).Intra-group comparison:Blood flow velocity of femoral vein,and popliteal vein in the two groups on postoperative day 1,7,and 14 was statistically significant(P<0.05).Comparison between groups:Blood flow velocity of femoral vein and popliteal vein in the observation group was significantly higher than that in the control group at 7 and 14 days after surgery,and the differences were statistically significant(P<0.05).After intervention,the scores of problem solving ability,communication and coordination ability,work enthusiasm,team sense and responsibility of nursing staff in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Postoperative nursing based on QCC can significantly reduce the incidence of postoperative DVT in patients with lower limb fracture and improve the comprehensive quality of nursing staff.