循证护理预防下肢创伤骨折深静脉血栓形成效果的最佳证据总结及临床应用效果

Summary of the best evidence for the effectiveness of evidence-based care in preventing deep vein thrombosis in lower limb trauma fractures and the effect of clinical application

目的:探讨运用循证护理预防下肢创伤骨折深静脉血栓形成的临床应用效果。方法:查阅文献并进行归纳总结,提取能够有效预防下肢创伤骨折深静脉血栓形成的干预方法。挑选南方医科大学附属广东省人民医院关节骨病及创伤科2022年5—6月29例下肢创伤骨折患者作为A组,并分析下肢创伤骨折深静脉血栓发生的风险因素;选取7—8月31例下肢创伤骨折患者作为B组,运用总结出的循证依据进行干预,观察两组有效干预执行率,患者抬高患肢执行率、患者首次下床时间等指标,并进行评价。结果:共纳入15条文献,提取10项证据,将其用于临床干预,结果显示,证据应用前,仅项目5、项目6合格率>60%,其他项目均未达合格标准。证据应用后,10个项目合格率均>60%,项目合格率100%,显著高于证据应用前(P<0.05)。项目4、项目5证据应用前后合格率比较,差异无统计学意义(P>0.05),其余项目证据应用后合格率均高于证据应用前,差异有统计学意义(P<0.05)。B组患者首次下床时间早于A组,差异有统计学意义(P<0.05);两组深静脉血栓发生率、住院时间比较,差异无统计学意义(P>0.05)。结论:基于循证护理的积极干预,可以提高护理人员的知识水平,降低下肢创伤骨折患者DVT发生率,促进其早进行下地活动。

Objective To explore the clinical application effects of evidence-based nursing in preventing lower limb trauma,fractures,and deep vein thrombosis(DVT).Methods The literature was reviewed and summarized,and the intervention methods that can effectively prevent deep vein thrombosis of lower limb traumatic fracture were extracted.Twenty-nine patients with lower extremity traumatic fractures from May to June 2022 in the Department of Joint and Orthopaedic Disease and Trauma,Guangdong Provincial People's Hospital Affiliated to Southern Medical University were selected as group A,and the risk factors of deep venous thrombosis in lower extremity traumatic fractures were analyzed.From July to August,31 patients with lower extremity traumatic fractures were selected as group B,and the evidence-based evidence was used for intervention.The effective intervention execution rate,the patient's elevation of the affected limb execution rate,and the patient's first time to get out of bed were observed and evaluated.Results A total of 15 articles were included,and 10 items of evidence were extracted and used for clinical intervention.The results showed that before the application of evidence,only item 5 and item 6 had a pass rate of>60%,and other items were not qualified.After the application of evidence,the qualified rate of 10 items was>60%,and the qualified rate of the project was 100%,which was significantly higher than that before the application of evidence(P<0.05).The qualified rate of the remaining items after the application of evidence was higher than that before the application of evidence,and the difference was statistically significant(P<0.05).The first time of getting out of bed in group B was earlier than that in group A,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of deep vein thrombosis and hospitalization time between the two groups(P>0.05).Conclusions Positive intervention based on evidence-based nursing can improve practitioners'knowledge levels,reduce the incidence of DVT in lower limb trauma fracture patients,and promote early ambulation.