基于Caprini量表的护理干预对降低单侧全髋关节置换术后深静脉血栓形成风险的效果
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摘要
目的探讨基于Caprini量表的护理干预对降低单侧全髋关节置换术(THR)后深静脉血栓(DVT)形成风险的效果。方法选取2017年9月—2018年1月收治的因单侧股骨头缺血性坏死行单侧THR的患者150例,随机分为对照组和观察组,各75例。对照组实施常规护理,观察组采用Caprini量表进行风险评估,根据发生DVT风险程度,实施个性化干预措施。观察2组患者患肢皮温、静脉血D-二聚体水平、出血量、周径情况,对比2组DVT发生例数。结果干预后,观察组肢体周径差值、出血量及术后8、72 h D-二聚体水平均低于对照组,差异有统计学意义(P<0.05)。对照组发生DVT例数7(9.33%)例,观察组发生DVT例数1(1.33%)例,观察组DVT发生率低于对照组(P<0.05)。结论运用Caprini量表对单侧THR住院患者进行血栓风险评估是预防患者发生DVT的关键,为实施个性化护理干预奠定了基础。
Objective To investigate the nursing interventions based on Caprini risk assessment scale in reducing the risk of deep-venous thrombosis(DVT) after unilateral total hip replacement(THR). Methods Totally 150 hospitalized patients with THR for ischemic necrosis of the femoral head were randomly divided into the control group and the observation group, with 75 cases in each group. The routine nursing management was carried out in the control group. In the observation group, patients were evaluated with Caprini risk assessment scale, and individualized interventions were made according to level of risk to DVT development. The lower-limb skin temperature, D-dimer levels, amount of bleeding, changes in diameter of lower limb were observed, and the incidence of DVT was compared between two groups. Results The changes in diameter of lower limb, amount of bleeding and D-dimer levels at 8 and 72 hours after surgery were lower in the observation group than those in the control group(P<0.05). The incidence of DVT in the observation group was lower than that in the control group(1.33% vs. 9.33%, P<0.05). Conclusion The risk assessment of DVT by Caprini risk assessment scale is the key to prevent DVT in hospitalized THR patients and lay the foundation for implementation of individualized nursing interventions.
Objective To investigate the nursing interventions based on Caprini risk assessment scale in reducing the risk of deep-venous thrombosis(DVT) after unilateral total hip replacement(THR). Methods Totally 150 hospitalized patients with THR for ischemic necrosis of the femoral head were randomly divided into the control group and the observation group, with 75 cases in each group. The routine nursing management was carried out in the control group. In the observation group, patients were evaluated with Caprini risk assessment scale, and individualized interventions were made according to level of risk to DVT development. The lower-limb skin temperature, D-dimer levels, amount of bleeding, changes in diameter of lower limb were observed, and the incidence of DVT was compared between two groups. Results The changes in diameter of lower limb, amount of bleeding and D-dimer levels at 8 and 72 hours after surgery were lower in the observation group than those in the control group(P<0.05). The incidence of DVT in the observation group was lower than that in the control group(1.33% vs. 9.33%, P<0.05). Conclusion The risk assessment of DVT by Caprini risk assessment scale is the key to prevent DVT in hospitalized THR patients and lay the foundation for implementation of individualized nursing interventions.
引文
[1] 张学辉, 喻姣花, 褚婕, 等. 深静脉血栓风险评估研究进展及展望[J]. 护理研究, 2014, 28(32): 3982-3985.
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[3] 刘翠, 王筱慧, 陆清声, 等. 静脉血栓栓塞症发生情况调查及对策探讨[J]. 中国卫生质量管理, 2016, 23(4): 45-47.
[4] 谢煜, 包倪荣, 刘云, 等. 骨科大手术患者围手术期深静脉血栓预防策略研究[J]. 中华护理杂志, 2017, 52(7): 773-779.
[5] 张爱东. 股骨骨折患者80例围手术期下肢静脉血栓形成的预防护理体会[J]. 实用医技杂志, 2012, 19(12): 1353-1354.
[6] 汤俊峰, 尚希福, 胡飞, 等. 全髋关节置换术后引流管不同处理方式的临床比较研究[J]. 中国骨与关节损伤杂志, 2014, 29(4): 319-321.
[7] 刘粉霞. Autar量表评估指引下的早期护理干预对ICU患者DVT防治效果的探讨[J]. 世界最新医学信息文摘, 2017, 17(93): 266-267.
[8] STREIFF M B, CAROLAN H T, HOBSON D B, et al. Lessons from the johns hopkins multi-disciplinary venous thromboembolism (VTE) prevention collaborative[J]. BMJ, 2012, 344(6): e3935.
[9] 张成欢, 刘云. 骨科手术患者相关血栓形成风险评估的研究进展[J]. 医学研究生学报, 2015, 28(4): 445-448.
[10] LOBASTOV K, BARINOV V, SCHASTLIVTSEV I, et al. Validation of the Caprini risk assessment model for venous thromboembolism in high-risk surgical patients in the background of standard prophylaxis[J]. J Vasc Surg-Venous L, 2016, 4(2): 153-160.
[11] 徐园, 杨旭, 王晓杰, 等. 国内深静脉血栓预防护理现状的调查研究[J]. 中华护理杂志, 2015, 50(10): 1222-1225.
[12] WON Y S. Incidence and clinical characteristics of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with DVT chemoprophylaxis[J]. J Vasc Surg, 2015, 61(6): 166S-167S.
[13] 许建芬, 陈正香, 常青, 等. 深静脉血栓管理组的建立和临床应用[J]. 护理学报, 2015, 22(12): 20-21.
[14] SHIMOYAMA Y, SAWAI T, TATSUMI S, et al. Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty[J]. J Clin Anesth, 2012, 24(7): 531-536.
[15] OGER E. Incidence of venous thromboembolism: a community-based study in western france[J]. Thromb Haemost, 2000, 83(5): 657-660.
[2] 马玉芬, 邓海波, 陆欣欣, 等. 住院患者静脉血栓栓塞症风险管理体系的建立与临床实践[J]. 中国护理管理, 2017, 17(11): 1441-1445.
[3] 刘翠, 王筱慧, 陆清声, 等. 静脉血栓栓塞症发生情况调查及对策探讨[J]. 中国卫生质量管理, 2016, 23(4): 45-47.
[4] 谢煜, 包倪荣, 刘云, 等. 骨科大手术患者围手术期深静脉血栓预防策略研究[J]. 中华护理杂志, 2017, 52(7): 773-779.
[5] 张爱东. 股骨骨折患者80例围手术期下肢静脉血栓形成的预防护理体会[J]. 实用医技杂志, 2012, 19(12): 1353-1354.
[6] 汤俊峰, 尚希福, 胡飞, 等. 全髋关节置换术后引流管不同处理方式的临床比较研究[J]. 中国骨与关节损伤杂志, 2014, 29(4): 319-321.
[7] 刘粉霞. Autar量表评估指引下的早期护理干预对ICU患者DVT防治效果的探讨[J]. 世界最新医学信息文摘, 2017, 17(93): 266-267.
[8] STREIFF M B, CAROLAN H T, HOBSON D B, et al. Lessons from the johns hopkins multi-disciplinary venous thromboembolism (VTE) prevention collaborative[J]. BMJ, 2012, 344(6): e3935.
[9] 张成欢, 刘云. 骨科手术患者相关血栓形成风险评估的研究进展[J]. 医学研究生学报, 2015, 28(4): 445-448.
[10] LOBASTOV K, BARINOV V, SCHASTLIVTSEV I, et al. Validation of the Caprini risk assessment model for venous thromboembolism in high-risk surgical patients in the background of standard prophylaxis[J]. J Vasc Surg-Venous L, 2016, 4(2): 153-160.
[11] 徐园, 杨旭, 王晓杰, 等. 国内深静脉血栓预防护理现状的调查研究[J]. 中华护理杂志, 2015, 50(10): 1222-1225.
[12] WON Y S. Incidence and clinical characteristics of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with DVT chemoprophylaxis[J]. J Vasc Surg, 2015, 61(6): 166S-167S.
[13] 许建芬, 陈正香, 常青, 等. 深静脉血栓管理组的建立和临床应用[J]. 护理学报, 2015, 22(12): 20-21.
[14] SHIMOYAMA Y, SAWAI T, TATSUMI S, et al. Perioperative risk factors for deep vein thrombosis after total hip arthroplasty or total knee arthroplasty[J]. J Clin Anesth, 2012, 24(7): 531-536.
[15] OGER E. Incidence of venous thromboembolism: a community-based study in western france[J]. Thromb Haemost, 2000, 83(5): 657-660.