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评估循证标准化护理方案对急性脑卒中患者下肢深静脉血栓形成预防的影响:一项回顾性分析。

Evaluating the impact of an evidence-based standardized nursing protocol on lower-extremity deep vein thrombosis prevention in acute stroke patients: A retrospective analysis.

作者信息

Chen Xuemei, Feng Ling, Wang Rui, Tu Shuangyan, Wei Dan, Peng Chao

机构信息

Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2025 Aug 1;104(31):e43155. doi: 10.1097/MD.0000000000043155.

Abstract

Acute stroke remains a major global health concern, contributing significantly to mortality and long-term disability. Due to factors such as immobility, endothelial injury, and hypercoagulability, these patients face an elevated risk of developing lower-extremity deep vein thrombosis (DVT). This retrospective study aimed to evaluate the efficacy of an evidence-based standardized nursing protocol in preventing DVT among acute stroke patients, comparing its outcomes with traditional nursing approaches. We analyzed data from 176 acute stroke patients admitted to our hospital between January 2022 and December 2023. The cohort was divided into 2 groups: the intervention group (n = 84), which received structured evidence-based care involving risk stratification, pharmacological and mechanical prophylaxis, early mobilization, patient education, and close monitoring, and the control group (n = 92), which received conventional nursing care. Over a 6-month follow-up period, the incidence of DVT was markedly lower in the intervention group (2.38% vs 14.13%, P = .005). Additionally, the intervention group demonstrated significantly fewer complications, including urinary tract infections, pneumonia, recurrent stroke, and pressure ulcers (P < .05). Further, patients in the intervention group exhibited superior outcomes in neurological recovery, cognitive improvement, quality of life, and mitigation of anxiety and depressive symptoms (P < .05). These findings underscore that an evidence-based standardized nursing protocol not only reduces DVT risk but also enhances overall recovery and well-being in acute stroke patients. The study advocates for the wider implementation of such protocols in clinical practice to optimize patient outcomes poststroke.

摘要

急性中风仍然是一个重大的全球健康问题,对死亡率和长期残疾有重大影响。由于诸如活动不便、内皮损伤和高凝状态等因素,这些患者发生下肢深静脉血栓形成(DVT)的风险升高。这项回顾性研究旨在评估基于证据的标准化护理方案在预防急性中风患者DVT方面的疗效,并将其结果与传统护理方法进行比较。我们分析了2022年1月至2023年12月期间我院收治的176例急性中风患者的数据。该队列分为两组:干预组(n = 84),接受包括风险分层、药物和机械预防、早期活动、患者教育和密切监测在内的结构化循证护理;对照组(n = 92),接受常规护理。在6个月的随访期内,干预组DVT的发生率显著低于对照组(2.38%对14.13%,P = 0.005)。此外,干预组的并发症明显较少,包括尿路感染、肺炎、复发性中风和压疮(P < 0.05)。此外,干预组患者在神经功能恢复、认知改善、生活质量以及焦虑和抑郁症状缓解方面表现出更好的结果(P < 0.05)。这些发现强调,基于证据的标准化护理方案不仅可以降低DVT风险,还可以促进急性中风患者的整体康复和健康状况。该研究提倡在临床实践中更广泛地实施此类方案,以优化中风后患者的结局。

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