三位一体联动共管护理模式对老年骨折手术患者围手术期VTE的预防价值研究

Preventive Value of Trinity Linkage Co-management Nursing Model on Perioperative VTE in Elderly Patients Undergoing Fracture Surgery

目的探讨三位一体联动共管护理模式在老年骨折手术患者围手术期中预防静脉血栓栓塞症(VTE)的价值。方法采用2021年7月至2022年7月在我院进行骨折手术的100例老年骨折患者,按照乱数表法分为对照组和研究组,每组各50例。对照组采取骨折围手术期常规护理模式,研究组在对照组的基础上采用三位一体联动共管护理模式。比较两组的VTE发生率[深静脉血栓(DVT)发生率、肺栓塞(PE)发生率]、并发症总发生率(患肢肿胀率、伤口感染率、压力性损伤发生率)、住院时间及日常生活能力[改良Barthel指数评定量表(MBI)、生活质量、欧洲五维健康量表(EQ-5D)]改善情况。结果研究组的DVT发生率、VTE总发生率、患肢肿胀发生率、并发症总发生率、住院时间、术后EQ-5D评分显著低于对照组(P<0.05)。两组的PE发生率、创口感染发生率和压力性损伤发生率无显著差异性(P>0.05)。研究组的术后MBI评分显著高于对照组(P<0.05)。结论对于老年骨折手术患者,围手术期中采用三位一体联动共管护理模式可以有效降低患肢肿胀和VTE发生风险,改善其日常生活能力和生活质量,对实现快速康复出院有积极意义。

Objective To explore the value of trinity linkage co-management nursing model on the prevention of perioperative venous thromboembolism(VTE)in elderly patients undergoing fracture surgery.Methods 100 elderly patients with fractures who underwent fracture surgery in the hospital from July 2021 to July 2022 were divided into control group and study group with 50 cases in each group according to the random number table method.The control group adopted perioperative routine nursing model while the study group was given trinity linkage co-management nursing model on the basis of the control group.The incidence rate of VTE[incidence rate of deep venous thrombosis(DVT),incidence rate of pulmonary embolism(PE)],incidence rates of total complications(affected limb swelling rate,wound infection rate,incidence rate of stress injury),hospital stay,ability of daily living[Modified Barthel Index(MBI)]and quality of life[EuroQol-5 Dimensions(EQ5)]were compared between the two groups.Results The incidence rate of DVT,total incidence rate of VTE,incidence rate of affected limb swelling,total incidence rate of total complications,hospital stay and postoperative EQ-5D score in study group were significantly lower than those in control group(P<0.05),but there were no significant differences in the incidence rates of PE,wound infection and stress injury between the two groups(P>0.05).The MBI score in study group after surgery was significantly higher than that in control group(P<0.05).Conclusion For elderly patients undergoing fracture surgery,the application of trinity linkage co-management nursing model during perioperative period can effectively reduce the risk of affected limb swelling and VTE occurrence,and improve the ability of daily living and quality of life,and it has positive significance rapid rehabilitation discharge.