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危重症患者下肢深静脉血栓形成的危险因素及发生率

Risk factors and incidence of deep vein thrombosis in lower extremities among critically ill patients.

作者信息

Hong Kee Chun, Kim HwaSoon, Kim Jang Yong, Kwak Kyung Sun, Cho Ok Min, Cha Hui Yeol, Lim Sun Hye, Song Yu Jin

机构信息

College of Medicine, Inha University, Incheon, Korea.

出版信息

J Clin Nurs. 2012 Jul;21(13-14):1840-6. doi: 10.1111/j.1365-2702.2012.04112.x.

Abstract

AIMS AND OBJECTIVES

To investigate how many critically ill patients developed deep vein thrombosis (DVT) during their admission to intensive care units (ICU) and to compare the characteristics of patients with and without deep vein thrombosis.

BACKGROUND

Critically ill patients are a high-risk group for deep vein thrombosis because they typically have multiple risk factors, such as prolonged immobility, mechanical ventilation and old age.

DESIGN

A prospective observational study was employed.

METHODS

The subjects were 90 patients who were older than 18 years of age, who were admitted to an intensive care unit for more than five days and were not provided any prophylactic measures. Data were collected at a university hospital for five months. A duplex scan was performed on day 2.4 on average and repeated between days 5-7 to diagnose deep vein thrombosis. The iliac, femoral, popliteal and tibial veins were examined by compression and colour Doppler methods of the duplex scan by one technician.

RESULTS

Age, gender and body mass index were significant factors for deep vein thrombosis development (p < 0.05). Ten patients (11.1%) developed deep vein thrombosis during their stay in the intensive care units.

CONCLUSIONS

The incidence was lower than in Western studies in which patients were not provided prophylaxis, but may increase with an extended observation period as in previous studies.

RELEVANCE TO CLINICAL PRACTICE

The results of this study could allow ICU nurses to recognise the DVT incidence in critically ill patients. This result could lead to more active prevention and monitoring of DVT by ICU nurses, especially for high-risk patients, such as older or obese patients.

摘要

目的与目标

调查有多少危重症患者在入住重症监护病房(ICU)期间发生深静脉血栓形成(DVT),并比较发生和未发生深静脉血栓形成患者的特征。

背景

危重症患者是深静脉血栓形成的高危人群,因为他们通常有多种危险因素,如长期制动、机械通气和高龄。

设计

采用前瞻性观察性研究。

方法

研究对象为90例年龄大于18岁、入住重症监护病房超过5天且未采取任何预防措施的患者。在一家大学医院收集了5个月的数据。平均在第2.4天进行一次双功超声扫描,并在第5 - 7天重复进行以诊断深静脉血栓形成。由一名技术人员通过双功超声扫描的压迫和彩色多普勒方法检查髂静脉、股静脉、腘静脉和胫静脉。

结果

年龄、性别和体重指数是深静脉血栓形成的重要因素(p < 0.05)。10例患者(11.1%)在重症监护病房住院期间发生了深静脉血栓形成。

结论

该发病率低于未进行预防的西方研究,但可能如既往研究那样随着观察期延长而增加。

与临床实践的相关性

本研究结果可使ICU护士认识到危重症患者的DVT发病率。这一结果可能会使ICU护士对DVT进行更积极的预防和监测,尤其是对高危患者,如老年或肥胖患者。

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