Huang Shuwei, Cui Juan, Cao Lilin, Wang Bo, Jia Liqun, Wang Ruyue, Liu Chunyan
Department of Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China.
Medicine (Baltimore). 2025 May 30;104(22):e42446. doi: 10.1097/MD.0000000000042446.
This study evaluates the effectiveness of predictive nursing in preventing lower extremity deep vein thrombosis (DVT) in severe trauma patients compared with conventional care. This retrospective study included severe trauma patients hospitalized between October 2023 and January 2024. Patients were divided into an observation group (51 cases, predictive nursing) and a control group (69 cases, conventional care). Propensity score matching was used to balance baseline characteristics. Differences in DVT incidence, hospital stay, hematological indicators, complications, and rehabilitation outcomes were analyzed. DVT incidence was significantly lower in the observation group (8.90%) compared with the control group (26.70%, P < .05), with a relative risk reduction of 67%. Hospital stays were shorter in the observation group (14.2 ± 4.1 vs 16.5 ± 5.2 days, P = .03). Improvements in D-dimer levels, prothrombin time, and international normalized ratio were significant in the observation group (P < .05), indicating lower thrombosis risk. Hematocrit (HCT) and platelet count (PLT) remained stable, showing significant differences compared with the control group (P < .05). Rehabilitation outcomes, including lower limb function and activity capacity, were significantly better in the observation group (P < .05). The control group had 4 cases of pulmonary embolism, while none were observed in the observation group (P = .03). Predictive nursing based on Caprini risk assessment effectively reduces DVT incidence, improves hematological profiles, shortens hospital stays, and enhances recovery in severe trauma patients. This personalized care model shows excellent clinical potential.
本研究评估了与传统护理相比,预见性护理在预防严重创伤患者下肢深静脉血栓形成(DVT)方面的有效性。这项回顾性研究纳入了2023年10月至2024年1月期间住院的严重创伤患者。患者被分为观察组(51例,接受预见性护理)和对照组(69例,接受传统护理)。采用倾向得分匹配法平衡基线特征。分析了DVT发生率、住院时间、血液学指标、并发症及康复结局的差异。观察组的DVT发生率(8.90%)显著低于对照组(26.70%,P<0.05),相对风险降低了67%。观察组的住院时间较短(14.2±4.1天对16.5±5.2天,P=0.03)。观察组的D-二聚体水平、凝血酶原时间和国际标准化比值有显著改善(P<0.05),表明血栓形成风险较低。血细胞比容(HCT)和血小板计数(PLT)保持稳定,与对照组相比有显著差异(P<0.05)。观察组的康复结局,包括下肢功能和活动能力,明显更好(P<0.05)。对照组有4例发生肺栓塞,而观察组未观察到(P=0.03)。基于Caprini风险评估的预见性护理可有效降低严重创伤患者的DVT发生率,改善血液学指标,缩短住院时间,并促进康复。这种个性化护理模式显示出优异的临床潜力。