血栓预防操联合预警分级管理在老年髋部骨折患者中的应用

Application of thrombosis prevention exercises combined with early warning graded management in elderly patients with hip fractures

目的探讨血栓预防操联合预警分级管理在老年髋部骨折患者中的应用效果,以期为临床治疗提供参考。方法本研究选取2020年1月—2023年6月成都市龙泉驿区第一人民医院收治的200例老年髋部骨折患者为研究对象。采用随机数字表法将患者分为观察组与对照组,每组100例。对照组患者采用常规健康护理干预,观察组患者在对照组基础上采用血栓预防操联合预警分层管理干预。分别于干预前、出院时比较2组患者深静脉血栓(DVT)健康信念水平、血小板计数(PLT)、血小板体积(MPV)、血小板分布宽度(PDW)、凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)水平;比较2组患者住院期间DVT发生率;比较2组患者出院时护理满意度。结果出院时,2组患者DVT健康信念中疾病易得感、疾病严重性、健康行为益处、自我效能评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组患者DVT发生率比较,差异无统计学意义(P>0.05)。出院时,2组患者MPV和PDW均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者PLT比较,差异无统计学意义(P>0.05)。出院时,2组患者APTT、PT均长于干预前,且观察组均长于对照组,差异均有统计学意义(P<0.05);出院时,2组患者Fbg水平均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者护理满意度为96.00%,高于对照组的87.00%,差异有统计学意义(P<0.05)。结论实施血栓预防操联合预警分级管理,可增强老年髋部骨折患者健康信念,避免DVT风险的增加,改善血小板功能,纠正机体血凝状态,提高患者在护理过程中的满意度,值得临床推广应用。

Objective To explore the application effectiveness of thrombosis prevention exercises combined with early warning graded management in elderly patients with hip fractures,with the aim of providing evidence for clinical treatment.Methods This study included 200 elderly patients with hip fractures admitted to the First People's Hospital of Longquanyi District,Chengdu,from January 2020 to June 2023 as subjects.Patients were randomly allocated to an observation group and a control group,with 100 cases in each group.The control group received routine health care interventions,while the observation group received thrombosis prevention exercises combined with early warning graded management on top of the interventions given to the control group.The levels of health belief regarding deep vein thrombosis(DVT),platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),activated partial thromboplastin time(APTT),prothrombin time(PT),and fibrinogen(Fbg)levels were compared between the two groups before the intervention and at discharge.The incidence of DVT during hospitalization and the degree of satisfaction with nursing at discharge were also compared.Results At discharge,the scores of disease susceptibility,disease severity,benefits of health behavior,and selfefficacy in the DVT health belief were higher in both groups than before the intervention,and higher in the observation group compared to the control group,with statistically significant differences(P<0.05).No statistically significant difference was observed in the incidence of DVT between the two groups(P>0.05).At discharge,the MPV and PDW in both groups were lower than before the intervention,and lower in the observation group compared to the control group,with statistically significant differences(P<0.05).No statistically significant difference was found in PLT between the two groups(P>0.05).At discharge,the APTT and PT were longer in both groups than before the intervention,and longer in the observation group compared to the control group,with statistically significant differences(P<0.05).At discharge,the Fbg levels in both groups were significantly lower than before the intervention,and significantly lower in the observation group compared to the control group(P<0.05).The degree of satisfaction with nursing in the observation group was significantly higher than that in the control group(96.00%vs.87.00%;P<0.05).Conclusion Implementing thrombosis prevention exercises combined with early warning graded management can promote the health beliefs of elderly patients with hip frac-tures,prevent the increase of DVT risk,strengthen platelet function,correct the body's coagulation status,and increase pa-tient satisfaction with the nursing process.This method holds promise for promotion in clinical practice.