优化中医护理方案在预防脑梗死急性期患者下肢深静脉血栓形成中的护理研究
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摘要
目的通过对脑卒中急性期优化中医护理方案的临床验证,确定优化中医护理方案对预防缺血性气虚血瘀证脑卒中患者下肢静脉血栓(DVT)的临床疗效。方法选择我院2015年1月-2017年4月缺血性气虚血瘀证脑卒中急性期患者80例,按随机数字表法分为两组,每组40例。对照组运用我院常规西医治疗及护理方法预防卧床患者下肢深静脉血栓形成。观察组按照预先制定的优化中医护理方案进行辨证施护,并特别注重中医护理技术应用。结果两组患者入院后第1天、第7天、第14天的血浆粘度、全血还原粘度差异有统计学意义(P<0. 05),于入院第14天的全血粘度差异有统计学意义(P<0. 05)。两组患者干预前后下肢静脉多普勒指标及腘静脉多普勒指标差异有统计学意义(P<0. 05)。两组患者下肢肿胀程度差异无统计学意义(P>0. 05)。两组患者DVT发生情况差异有统计学意义(P<0. 05)。结论对缺血性气虚血瘀证脑卒中患者实施"中风(脑梗死急性期)优化护理方案",能显著改善患者下肢深静脉血流速度、降低血粘度、预防肿胀、减少DVT的发生。
Objective To study optimizing TCM nursing program in the prevention of acute ischemic stroke deep venous thrombosis( DVT) patients with Qi deficiency and blood stasis syndrome through clinical verification. Methods 80 patients with acute ischemic stroke of Qi deficiency and blood stasis syndrome were randomly divided into two groups with 40 cases in each group. Routine western medical treatment and nursing methods were used in control group to prevent the formation of bedridden patients with deep venous thrombosis of lower limbs. The optimized TCM nursing program was applied in experimental group with syndrome and pattern differentiation of nursing,and particularly emphasize on the application of TCM nursing technique. Results There were significant difference in plasma viscosity and whole blood reduction viscosity between the two groups on the first day,the seventh day and the fourteenth day after admission( P<0.05).The was significant difference in the whole blood reducing viscosity on the 14 th day of admission( P < 0. 05). There were significant differences in Doppler index of lower extremity vein and popliteal vein between the two groups before and after intervention( P<0.05),and there aws no significant difference in the degree of lower extremity swelling between the two groups( P>0.05).There was significant difference in DVT between the two groups( P < 0. 05). Conclusions Application of " stroke( acute cerebral infarction) optimal care program" in acute ischemic stroke of Qi deficiency and blood stasis syndrome patients can significantly improve the flow of lower extremity blood flow,lower blood viscosity,prevent swelling and reduce the incidence of DVT.
Objective To study optimizing TCM nursing program in the prevention of acute ischemic stroke deep venous thrombosis( DVT) patients with Qi deficiency and blood stasis syndrome through clinical verification. Methods 80 patients with acute ischemic stroke of Qi deficiency and blood stasis syndrome were randomly divided into two groups with 40 cases in each group. Routine western medical treatment and nursing methods were used in control group to prevent the formation of bedridden patients with deep venous thrombosis of lower limbs. The optimized TCM nursing program was applied in experimental group with syndrome and pattern differentiation of nursing,and particularly emphasize on the application of TCM nursing technique. Results There were significant difference in plasma viscosity and whole blood reduction viscosity between the two groups on the first day,the seventh day and the fourteenth day after admission( P<0.05).The was significant difference in the whole blood reducing viscosity on the 14 th day of admission( P < 0. 05). There were significant differences in Doppler index of lower extremity vein and popliteal vein between the two groups before and after intervention( P<0.05),and there aws no significant difference in the degree of lower extremity swelling between the two groups( P>0.05).There was significant difference in DVT between the two groups( P < 0. 05). Conclusions Application of " stroke( acute cerebral infarction) optimal care program" in acute ischemic stroke of Qi deficiency and blood stasis syndrome patients can significantly improve the flow of lower extremity blood flow,lower blood viscosity,prevent swelling and reduce the incidence of DVT.
引文
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[7]吕红姣,崔丽笙.针刺联合中药熏蒸治疗脑卒中后肩手综合征的效果观察[J].护理与康复,2013,12(7):696-698.
[8]陈佳,张国庆,周湘明,等.中药熏蒸结合巴氯芬治疗脑卒中偏瘫痉挛临床观察[J].中国康复理论与实践,2010,16(2):170-171.
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[10]王晓旸,李庆利,鲍远程.补阳还五汤治疗中风病恢复期临床观察[J].中医药临床杂志,2010,22(11):994-995.
[11]付振,张念.补阳还五汤的药理研究[J].中国医学创新,2010,7(6):178-179.
[12]高志娴,聂明毅,王琰.下肢深静脉血栓的预防及护理[J].现代预防医学,2006,33(9):1729.
[13]顾巧华,陈张洁.预防脑卒中偏瘫病人下肢深静脉血栓的护理[J].全科护理,2012,10(5):1166-1167.
[14]高立强,陈伟.78例急性脑卒中合并下肢静脉血栓回顾性研究[J].临床荟萃,2015,30(2):216-218.
[15]郭燕,邱红海,王玲丽.中医护理在预防下肢深静脉血栓形成中的应用[J].光明中医,2012,27(11):2318-2319.
[16]丛晓荣,潘维亮.疏血通注射液预防胫骨骨折术后下肢深静脉血栓形成的疗效[J].中国医药,2012,7(12):1568-1569.
[17]陶方,季红莉,李中侠,等.高龄住院患者下肢深静脉血栓形成的临床分析及护理[J].河北医药,2015,37:2385-2387.
[2]皮永前,朱明霞.超声与凝血、纤溶指标对下肢深静脉血栓及血栓前状态的评价[J].血栓与止血学,2013,19(4):153-155.
[3] Turpie A G.Prophylaxis of venous thromboembolism in stroke patients[J].Semin Thromb Hemost,1997,23(2):155-157.
[4]国家中医院管理局脑病急症协作组.中风病中医诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,42(2):146-153.
[6]国家中医药管理局.关于印发中风等13个病种中医护理方案(试行)的通知[S].2013-05-16.
[7]吕红姣,崔丽笙.针刺联合中药熏蒸治疗脑卒中后肩手综合征的效果观察[J].护理与康复,2013,12(7):696-698.
[8]陈佳,张国庆,周湘明,等.中药熏蒸结合巴氯芬治疗脑卒中偏瘫痉挛临床观察[J].中国康复理论与实践,2010,16(2):170-171.
[9]张莉,陈眉.综合疗法治疗脑卒中患者37例临床疗效观察[J].浙江中医药大学学报,2009,33(6):12-13.
[10]王晓旸,李庆利,鲍远程.补阳还五汤治疗中风病恢复期临床观察[J].中医药临床杂志,2010,22(11):994-995.
[11]付振,张念.补阳还五汤的药理研究[J].中国医学创新,2010,7(6):178-179.
[12]高志娴,聂明毅,王琰.下肢深静脉血栓的预防及护理[J].现代预防医学,2006,33(9):1729.
[13]顾巧华,陈张洁.预防脑卒中偏瘫病人下肢深静脉血栓的护理[J].全科护理,2012,10(5):1166-1167.
[14]高立强,陈伟.78例急性脑卒中合并下肢静脉血栓回顾性研究[J].临床荟萃,2015,30(2):216-218.
[15]郭燕,邱红海,王玲丽.中医护理在预防下肢深静脉血栓形成中的应用[J].光明中医,2012,27(11):2318-2319.
[16]丛晓荣,潘维亮.疏血通注射液预防胫骨骨折术后下肢深静脉血栓形成的疗效[J].中国医药,2012,7(12):1568-1569.
[17]陶方,季红莉,李中侠,等.高龄住院患者下肢深静脉血栓形成的临床分析及护理[J].河北医药,2015,37:2385-2387.