Padua量表在干预PICC导管相关性静脉血栓中的应用和研究

A Study of Padua Risk Assessment Model in the Prevention of PICC-associated Venous Thrombus

目的研究血栓风险评估(Padua)量表运用于经外周置入中心静脉导管(PICC)导管相关性静脉血栓中的评估价值。方法选择2021年6月-2022年6月期间在我院PICC专科门诊接受置管和导管维护的82例肿瘤患者为研究对象,通过随机列表法分为41例对照组与41例观察组,其中对照组在PICC置管前给予常规评估,而观察组在对照组的基础上使用Padua量表对患者进行综合全面的评估,对比两组并发症、PICC导管相关性静脉血栓的发生率、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、满意度、医疗费用、下床活动及住院时长。结果观察组PICC导管相关性静脉血栓的发生率4.88%低于对照组19.51%(P<0.05)。两组干预前的凝血指标并无差别(P>0.05),干预后观察组PT、APTT、TT均低于对照组,但FIB高于对照组(P<0.05)。观察组并发症9.76%少于对照组29.27%(P<0.05)。观察组在风险评估、护理服务、预防措施、操作专业性上的满意度高出对照组(P<0.05)。观察组医疗费用、下床活动及住院时长均少于对照组(P<0.05)。结论Padua量表在评估PICC导管相关性静脉血栓中效果显著,可有效改善患者凝血功能,减少并发症及PICC导管相关性静脉血栓的发生率,同时缩短住院时长,降低医疗费用,患者满意度高,值得推广。

Objective To study the Padua risk assessment model in the prevention of PICC(peripherally inserted central catheter)-associated venous thrombus.Methods 82 tumor patients of undergoing the catheter indwelling and maintenance from June 2021 to June 2022 in our hospital were selected as research subjects.According to random number table,patients were assigned to control group(n=41)and observation group(n=41).Prior to the catheter indwelling,the routine assessment was applied in the control group;on the basis of the former,Padua risk assessment model-based comprehensive assessment was applied in the observation group.Clinical outcomes were appraised through the treatment complications,the occurrences of PICC-associated venous thrombus,prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),patient’s satisfaction,treatment costs,ambulant time and hospital stays.Results The occurrences of PICC-associated venous thrombus in the observation group(4.88%)was lower than that of control group(19.51%)(P>0.05);before intervention,the blood coagulation indicators between groups were not significantly different(P<0.05);after intervention,PT,APTT and TT values in the observation group were smaller than those of control group;but FIB contents were higher than those of control group(P<0.05);the treatment complication rates in the observation group(9.76%)were lower than those of control group(29.27%)(P<0.05);the satisfaction scores of risk assessment,nursing services,prevention measures and operation skills in the observation group were higher than those of control group(P<0.05);compared with control group,the treatment costs,ambulant time and hospital stays in the observation group were obviously reduced(P<0.05).Conclusion Padua risk assessment model can effectively reduce the surgical complications,the occurrences of PICC-associated venous thrombus,hospital stays and treatment costs,improve the blood coagulation function and patient’s satisfaction.It is worthy of clinical promotion.