基于质量敏感指标的综合管理模式对老年颅脑手术患者术中下肢深静脉血栓的预防效果

Evaluation of the effectiveness of a comprehensive management model based on quality sensitive indicators on preventing intraoperative deep vein thrombosis in lower limbs in elderly patients undergoing craniocerebral surgery

目的 研究基于质量敏感指标的综合管理模式在老年颅脑手术患者术中下肢深静脉血栓预防中的效果。方法 选取2021年1月至2023年6月南京医科大学第一附属医院收治的88例老年颅脑手术患者为研究对象,根据不同的干预方式将患者随机分为对照组与观察组,每组44例。对照组采取常规护理,观察组在对照组基础上予以基于质量敏感指标的综合管理模式,比较干预后2组患者术中下肢深静脉血栓形成情况、干预前后2组患者神经功能、下肢功能、日常生活能力及护理满意度。结果 干预前2组NIHSS评分、FMA-L评分、BI评分比较,差异无统计学意义(P>0.05);干预后观察组术中下肢深静脉血栓形成率和NIHSS评分明显低于对照组(P<0.05),FMA-L评分、BI评分及护理满意度明显高于对照组(P<0.05)。结论 基于质量敏感指标的综合管理模式可有效预防老年颅脑手术患者术中下肢深静脉血栓形成,同时还能改善患者的神经功能,提高患者的下肢功能、日常生活能力及满意度。

Objective To study the effectiveness of a comprehensive management model based on quality sensitive indicators on preventing intraoperative deep vein thrombosis(DVT)in lower limbs in elderly patients undergoing craniocerebral surgery.Methods A total of 88 elderly patients undergoing craniocerebral surgery in the First Affiliated Hospital with Nanjing Medical University from January 2021 to June 2023 were selected as the research subjects.According to different intervention methods,patients were randomly divided into the control group and observation group,with 44 cases per group.Patients in the control group received routine nursing care,while those in the observation group received a comprehensive management model based on quality sensitive indicators plus routine nursing care.The incidence of intraoperative DVT in the lower limbs,neurological function,lower limb function,daily living ability,and nursing satisfaction were compared before and after interventions between groups.Results There were no significant differences in the National Institutes of Health Stroke Scale(NIHSS)score,Fugl-Meyer Assessment of Lower Extremity(FMA-LE)score,and the Barthel Index(BI)before the intervention between groups(P>0.05).The incidence of intraoperative DVT in the lower limbs after the intervention was significantly lower in the observation group than the control group(P<0.05).After intervention,patients in the observation group had significantly lower NIHSS score,higher FMA-LE score,BI and nursing satisfaction than those of the control group(P<0.05).Conclusion The comprehensive management model based on quality sensitive indicators can effectively prevent intraoperative DVT in lower limbs,and improve neurological function,lower limb function,daily living ability,and nursing satisfaction in elderly patients undergoing craniocerebral surgery.