循证综合护理结合早期活动量表在老年胃肠癌患者术后深静脉血栓预防中的应用

Application of evidence-based comprehensive nursing combined with early activity scale in the prevention of deep vein thrombosis in elderly patients after gastrointestinal cancer surgery

目的考察循证综合护理结合早期活动量表在老年胃肠癌患者术后深静脉血栓(DVT)预防中的应用效果。方法选取2021年2月至2022年10月于济南市中西医结合医院行手术治疗的90例老年胃肠癌患者作为研究对象,根据干预方式的不同分为对照组(45例)和观察组(45例)。对照组给予常规干预,观察组给予循证综合护理结合早期活动量表干预。比较2组的凝血功能水平、下肢静脉血流峰值速度及平均速度、生活质量、心理弹性、DVT发生率和护理满意度。结果手术后14 d,2组的D-二聚体(D-D)水平均低于手术后1 h和7 d,凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)均长于手术后1 h和7 d,下肢静脉血流峰值速度和平均速度均快于手术后1 h和7 d,健康调查量表36(SF-36)和心理弹性量表(CD-RISC)评分均高于手术后1 h和7 d,组内差异均有统计学意义(P均<0.05);手术后7 d和14 d,观察组的D-D水平均低于同期对照组,PT和APTT均长于同期对照组,下肢静脉血流峰值速度和平均速度均比同期对照组更快,SF-36评分和CD-RISC评分均高于同期对照组,组间差异均有统计学意义(P均<0.05)。观察组的DVT发生率低于对照组,护理满意度评分高于对照组(P均<0.05)。结论循证综合护理结合早期活动量表可降低老年胃肠癌患者的术后DVT发生率,改善其凝血状态和下肢血流速度,提高其生活质量和心理弹性,且护理满意度较高。

Objective To investigate the application effect of evidence-based comprehensive nursing combined with early activity scale in the prevention of deep vein thrombosis(DVT)in elderly patients after surgery for gastrointestinal cancer.Methods Ninety elderly patients with gastrointestinal cancer who underwent surgical treatment at Jinan Integrated Traditional Chinese and Western Medicine Hospital from February 2021 to October 2022 were selected as the research subjects.According to the different intervention methods,they were assigned into a control group(45 cases)and an observation group(45 cases).The control group received routine intervention,while the observation group received evidence-based comprehensive nursing combined with intervention of early activity scale.The level of coagulation function,peak and average velocity of lower limb venous flow,quality of life,psychological resilience,incidence of DVT,and nursing satisfaction were compared between the two groups.Results At 14 days after surgery,the level of D-dimer(D-D)in both groups was lower than that at 1 h and 7 days after surgery.The prothrombin time(PT)and activated partial thromboplastin time(APTT)were longer than those at 1 h and 7 days after surgery.The peak and average velocity of lower limb venous flow were faster than those at 1 h and 7 days after surgery.The scores of the Short Form-36 Health Survey(SF-36)and the Connor-Davidson Resilience Scale(CD-RISC)were higher than those at 1 h and 7 days after surgery.The differences within the group were statistically significant(all P<0.05).At 7 and 14 days after surgery,the D-D level in the observation group was lower than that in the control group,and the PT and APTT were longer than those in the control group.The peak and average velocity of lower limb venous flow were faster than those in the control group.The SF-36 and CD-RISC scores were higher than those in the control group.The incidence of DVT in the observation group was lower than that in the control group,and the nursing satisfaction score was higher than that in the control group.The differences between the groups were statistically significant(all P<0.05).Conclusion The combination of evidence-based comprehensive nursing and early activity scale can reduce the incidence of postoperative DVT in elderly patients with gastrointestinal cancer,enhance their coagulation status and lower limb blood flow velocity,improve their quality of life and psychological resilience,and lead to a high level of nursing satisfaction.