基于His系统的肝胆胰肿瘤手术患者静脉血栓栓塞症防治链式管理方案的构建及应用

Construction and Application of a Chain Management Scheme for Prevention and Treatment of Venous Thromboembolism in Patients Undergoing Hepatobiliary Pancreatic Tumor Surgery Based on His System

目的 构建静脉血栓栓塞症(VTE)防治链式管理方案,探讨链式管理方案在肝胆胰腺恶性肿瘤手术患者中的应用效果。方法 实施非同期对照,整群抽取2022年3—7月某三级甲等医院肝胆胰外科肝胆胰腺恶性肿瘤手术患者为对照组,整群抽取2022年8—12月肝胆胰腺恶性肿瘤手术患者为观察组。对照组采用常规VTE管理方法,观察组基于His系统多学科合作,实施围术期VTE防治链式管理。比较两组患者穿着抗血栓弹力袜相关健康教育的知晓率、VTE预防知识知晓率、D-二聚体、静脉血栓栓塞症发生率指标是否有统计学差异。结果 观察组患者对穿着抗血栓弹力袜相关健康教育的知晓率与对VTE预防知识知晓率均优于对照组,D-二聚体、静脉血栓栓塞症发生率均低于对照组,差异有统计学意义(P<0.05)。结论 基于His系统构建静脉血栓栓塞症防治链式管理方案可降低肝胆胰恶性肿瘤手术患者静脉血栓栓塞症发生率,提高围术期护理质量。

Objective To construct a chain management scheme for the prevention and treatment of venous thromboembolism(VTE),and explore the application effect of the chain management scheme in patients suffered from hepatobiliary and pancreatic malignant tumors and underwent surgery.Methods Method of non-concurrent control was employed,121 patients suffered from hepatobiliary and pancreatic malignant tumors and underwent surgery in a tertiary grade A hospital from March 2022 to July 2022 were selected as the control group using cluster sampling method,and 125 patients underwent surgery from August 2022 to December 2022 were selected as the observation group.The control group used conventional VTE management methods.Based on the His system,the test group implemented the perioperative VTE prevention chain management.The awareness ofwear anti-thrombotic elastic socks related health education,awareness ofVTE prevention,D-dimer and incidence of venous thromboembolism of the two groups were compared.Results Both the awareness rate of wear anti-thrombotic elastic socks related health education and VTE prevention of the observation group were better than the control group;the incidence of D-dimer and venous thromboembolism were lower than those of the control group,the difference was statisticallysignificant(P<0.01).Conclusions The chain management scheme for VTE prevention and treatment based on His system can reduce the incidence of VTE among patients underwentsurgery due to hepatobiliary and pancreatic malignancy tumor,and improve the quality of perioperative care.