血栓风险评估结合集束化护理对骨科创伤患者深静脉血栓的影响

doi:10.3760/cma.j.cn441417-20250213-13033

摘要/Abstract

摘要：

目的　分析血栓风险评估结合集束化护理对骨科创伤患者深静脉血栓的影响。方法　回顾性分析2023年12月至2024年11月期间商洛市中医医院骨伤三科收治的106例创伤患者，根据随机数字表法将其分为参照组和干预组，各53例。参照组男29例，女24例，年龄（46.27±6.13）岁；干预组男27例，女26例，年龄（45.83±5.94）岁。参照组实施常规护理模式，干预组实施血栓风险评估结合集束化护理模式，两组均干预1个月。比较两组护理前后下肢血流速度（腘窝静脉、股总静脉、股浅静脉血流速度）、凝血功能指标［凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）以及纤维蛋白原（FIB）］、生活质量（躯体功能、心理功能、物质生活、社会功能）、深静脉血栓发生及护理满意度。采用χ²检验、t检验进行统计分析。结果　干预1个月后，干预组的腘窝静脉、股总静脉、股浅静脉血流速度均高于参照组［（15.34±1.61）cm/s比（13.89±1.83）cm/s、（19.43±1.38）cm/s比（17.43±1.52）cm/s、（16.53±1.64）cm/s比（15.46±1.15）cm/s］，差异均有统计学意义（t=4.331、-7.092、-3.889，P<0.05）；干预组的PT、APTT水平均高于参照组［（20.34±2.64）s比（16.79±2.57）s、（14.85±2.74）s比（12.04±2.68）s］，FIB水平低于参照组［（5.53±0.72）g/L比（6.20±1.04）g/L］，差异均有统计学意义（t=-7.015、-5.337、-3.856，均P<0.001）；干预组生活质量综合评定问卷-74的躯体功能、心理功能、物质生活、社会功能评分均高于参照组（均P<0.001）。干预组患者的护理总满意率高于参照组［98.11%（52/53）比86.79%（46/53）］，深静脉血栓发生率低于参照组［3.77%（2/53）比16.98%（9/53）］，差异均有统计学意义（均P<0.05）。结论　在骨科创伤患者中实施血栓风险评估结合集束化护理，能够改善患者的下肢静脉血流速度及凝血功能，提高生活质量，减少深静脉血栓发生风险，护理满意度较高。

关键词: 深静脉血栓, 创伤, 血栓风险评估, 集束化护理

Abstract:

Objective　To analyze the effect of thrombosis risk assessment combined with cluster nursing on deep venous thrombosis in patients with orthopedic trauma. Methods　A retrospective analysis was conducted on 106 trauma patients admitted to department of Orthopedics, Shangluo Traditional Chinese Medicine Hospital from December 2023 to November 2024. Patients were divided into a reference group and an intervention group, with 53 cases in each group, using a random number table method. The reference group comprised 29 males and 24 females, aged (46.27±6.13) years; the intervention group had 27 males and 26 females, aged (45.83±5.94) years. The reference group was given routine nursing mode, and the intervention group was given thrombosis risk assessment combined with cluster nursing mode. Both groups were intervened for 1 month. The two groups were compared before and after nursing intervention regarding lower limb blood flow velocity (popliteal vein, total femoral vein, superficial femoral vein), coagulation function indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB)], quality of life (physical function, psychological function, material life, social function), incidence of deep venous thrombosis, and nursing satisfaction. Statistical analysis was performed using χ² test and t test. Results　After 1 month of intervention, the blood flow velocity of popliteal vein, common femoral vein and superficial femoral vein in the intervention group were all higher than those in the reference group [(15.34±1.61) cm/s vs. (13.89±1.83) cm/s, (19.43±1.38) cm/s vs. (17.43±1.52) cm/s, (16.53±1.64) cm/s vs. (15.46±1.15) cm/s], with statistically significant differences (t=4.331, -7.092, -3.889, P<0.05). The levels of PT and APTT in the intervention group were higher than those in the reference group [(20.34±2.64) s vs. (16.79±2.57) s, (14.85±2.74) s vs. (12.04±2.68) s], while FIB was lower in the intervention group [(5.53±0.72) g/L vs. (6.20±1.04) g/L], with all differences being statistically significant (t=-7.015, -5.337, -3.856, all P<0.001). The scores for physical function, psychological function, material life, and social function in the Quality of Life Comprehensive Assessment Questionnaire-74 were higher in the intervention group than in the reference group (all P<0.001). The overall nursing satisfaction rate in the intervention group was higher than that in the reference group [98.11% (52/53) vs. 86.79% (46/53)], and the incidence of deep venous thrombosis was lower in the intervention group [3.77% (2/53) vs. 16.98% (9/53)], with both differences being statistically significant (all P<0.05). Conclusion　The implementation of thrombosis risk assessment combined with cluster nursing in patients with orthopedic trauma can improve the venous blood flow velocity and coagulation function of lower limbs, improve the quality of life, reduce the risk of deep venous thrombosis, and have higher nursing satisfaction.

Key words: Deep , venous , thrombosis, , Trauma, , Risk assessment of thrombosis, , Cluster nursing

王亚莉刘宁宋波涛.

血栓风险评估结合集束化护理对骨科创伤患者深静脉血栓的影响 [J]. 国际医药卫生导报, 2025, 31(13): 2273-2277.

Wang Yali, Liu Ning, Song Botao.

The effect of thrombosis risk assessment combined with cluster nursing on deep venous thrombosis in orthopedic trauma [J]. International Medicine and Health Guidance News, 2025, 31(13): 2273-2277.

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