术后下肢深静脉血栓形成的危险因素分析及其治疗与护理
Analysis of Risk Factors for Postoperative Lower Extremity Deep Venous Thrombosis and its Treatment and Nursing.
作者信息
Liu Huayun, Peng Yunhua
机构信息
The Affiliated Nanhua Hospital,Department of Gastroenterology, Hengyang Medical College, University of South China, Hengyang, Hunan 421001, China.
The Affiliated Nanhua Hospital,Department of Spine Surgery, Hengyang Medical College, University of South China, Hengyang, Hunan 421001, China.
出版信息
Emerg Med Int. 2022 Sep 8;2022:9180696. doi: 10.1155/2022/9180696. eCollection 2022.
OBJECTIVE
To explore the risk factors of lower extremity deep venous thrombosis (LEDVT) after surgery and discuss the treatment and nursing countermeasures.
METHODS
A retrospective analysis was conducted on 268 surgical patients admitted between July to December 2021. The factors associated with LEDVT were analyzed using the Logistic regression model. Further, LEDVT patients were assigned to a research group treated with targeted nursing to prevent LEDVT and a control group that used routine care. Coagulation function and inflammatory cytokines before and after nursing intervention were compared between groups. The assessment of patients' mobility employed the lower limb motor function part of the Fugel-Meyer Assessment (FMA), Harris Hip Score (HHS), and Barthel index (BI), and their psychological status was evaluated using the Kolcaba's General Comfort Questionnaire (GCQ) and Self-rating Anxiety/Depression Scale (SAS/SDS). Finally, patient satisfaction with the treatment service was investigated.
RESULTS
Logistic regression analysis showed that hypertension, limb paralysis, central venous catheterization of lower limbs, and bedridden time affect postoperative LEDVT in an independent way ( < 0.05). After the intervention, the coagulation function and inflammatory reaction were improved in both groups, with more significant improvement in the research group ( < 0.05). The research group also showed higher FMA, Harris, GCQ, and BI scores while lower SAS and SDS scores than the control group postnursing intervention ( < 0.05). Finally, a higher satisfaction rate was identified in the research group as compared to the control group ( < 0.05).
CONCLUSION
Hypertension, limb paralysis, CVC of lower limbs, and bedridden time are all independent risk factors for LEDVT after surgery. The implementation of targeted nursing strategies for the above factors can effectively alleviate the hypercoagulable state of patients after operation, reduce inflammatory responses, and improve patient comfort, which is of great significance for preventing the occurrence of LEDVT.
目的
探讨手术后下肢深静脉血栓形成（LEDVT）的危险因素，并探讨其治疗及护理对策。
方法
对2021年7月至12月收治的268例手术患者进行回顾性分析。采用Logistic回归模型分析与LEDVT相关的因素。此外，将LEDVT患者分为采用针对性护理预防LEDVT的研究组和采用常规护理的对照组。比较两组护理干预前后的凝血功能和炎症细胞因子。采用Fugel-Meyer评估量表（FMA）下肢运动功能部分、Harris髋关节评分（HHS）和Barthel指数（BI）评估患者的活动能力，采用Kolcaba一般舒适度问卷（GCQ）和自评焦虑/抑郁量表（SAS/SDS）评估患者的心理状态。最后，调查患者对治疗服务的满意度。
结果
Logistic回归分析显示，高血压、肢体瘫痪、下肢中心静脉置管和卧床时间独立影响术后LEDVT（<0.05）。干预后，两组的凝血功能和炎症反应均有所改善，研究组改善更显著（<0.05）。护理干预后，研究组的FMA、Harris、GCQ和BI评分高于对照组，而SAS和SDS评分低于对照组（<0.05）。最后，研究组的满意度高于对照组（<0.05）。
结论
高血压、肢体瘫痪、下肢中心静脉置管和卧床时间均是手术后LEDVT的独立危险因素。针对上述因素实施针对性护理策略可有效缓解患者术后的高凝状态，减轻炎症反应，提高患者舒适度，对预防LEDVT的发生具有重要意义。
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