集束化干预措施在腹部肿瘤术后肺栓塞干预中的应用

Application of Cluster Intervention Measure in the Intervention of Pulmonary Embolism after Abdominal Tumors Surgery

目的探究集束化干预措施在腹部肿瘤患者术后的应用效果及对患者术后肺栓塞(PE)发生率、生活质量的影响。方法选取2015年6月—2018年9月湖北省襄阳市中心医院腹部肿瘤科收治的180腹部肿瘤患者为研究对象,采用随机数字表分为观察组与对照组,各90例。对照组术后行常规干预,观察组术后给予集束化干预措施。比较两组术后凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]变化、干预前后PE基础知识得分、自我效能感[一般自我效能感量表(GSES)]、下肢静脉血栓(DVT)和PE发生率、生活质量[生活质量指数(QL-Index)量表]。结果术后5 d,两组APTT、FIB、D-D均高于术前(P<0.05),但观察组APTT高于对照组而FIB、D-D均低于对照组(P<0.05);干预后,两组PE基础知识、GSES得分均显著高于干预前(P<0.05),且观察组PE基础知识、GSES得分均显著高于对照组(P<0.05);观察组DVT发生率5.56%及PE发生率0均显著低于对照组的18.89%、6.67%(P<0.05);两组QL-Index各维度评分均较干预前升高(P<0.05),且观察组显著高于对照组(P<0.05)。结论集束化干预措施用于腹部肿瘤患者术后干预中,对患者术后凝血指标控制有积极影响,还可以提高患者对PE认知程度、增强患者自我效能感,有利于降低患者DVT及PE发生率,提高患者生活质量。

Objective To explore the application effects of cluster intervention measure on postoperative patients with abdominal tumors and its influence on incidence rate of postoperative pulmonary embolism(PE)and quality of life.Methods A total of 180 patients with abdominal tumors admitted to department of abdominal tumors of Xiangyang Central Hospital from June 2015 to September 2018 were selected for the study and were divided into observation group and control group according to the random number table method,with 90 cases in each group.Control group was given routine intervention after surgery,and observation group was given cluster intervention measure after surgery.The postoperative coagulation function indexes[activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)],PE basis knowledge score,self-efficacy[General Self-Efficacy Scale(GSES)],incidence rates of lower extremity deep venous thrombosis(DVT)and PE,and quality of life[quality of life index(QL-Index)scale]before and after intervention were compared between the two groups.Results At 5 d after surgery,the APTT,FIB and D-D were higher than those before surgery(P<0.05),but the APTT in observation group washigher than that in control group while the FIB and DD were lower than those in control group(P<0.05).After intervention,the scores of PE basic knowledge and GSES in the two groups were significantly higher than those before intervention(P<0.05),and the scores of PE basic knowledge and GSES in observation group were significantly higher than those in control group(P<0.05).The incidence rates of DVT and PE in observation group were significantly lower than those in control group(5.56%vs 18.89%,0.00%vs 6.67%)(P<0.05).The scores of dimensions of QL-Index in the two groups were higher than those before intervention(P<0.05),and the scores in observation group were significantly higher than those in control group(P<0.05).Conclusion Cluster intervention measure for postoperative intervention of patients with abdominal tumors has positive effects on the control of postoperative coagulation indexes.And it can also improve the patient’s cognition degree of PE and enhance the self-efficacy,and it is beneficial to reduce the incidence rate of DVT and PE and improve the quality of life of patients.