整体护理模式预防胸外科术后深静脉血栓形成的应用效果

doi:10.3760/cma.j.issn.1007-1245.2024.18.035

摘要/Abstract

摘要：

目的　探究胸外科术后患者采取整体护理模式对深静脉血栓形成（DVT）的预防效果。方法　前瞻性纳入2021年1月至2023年6月抚州市第一人民医院收治的80例胸外科手术患者，按照随机数字表法分为对照组和观察组，每组40例。对照组男25例，女15例；年龄（57.39±4.84）岁；疾病类型：肺癌22例，食管癌14例，肺良性病变4例；手术类型：胸腔镜下肺叶切除术17例，肺楔形切除术5例，胸膜活检固定术4例，食管切除术14例；采取常规护理，护理1周。观察组男24例，女16例；年龄（57.35±4.82）岁；疾病类型：肺癌21例，食管癌14例，肺良性病变5例；手术类型：胸腔镜下肺叶切除术17例，肺楔形切除术4例，胸膜活检固定术5例，食管切除术14例；采取整体护理模式干预，护理1周。比较两组术后DVT发生率、术后恢复时间、心理状况［焦虑自评量表（SAS）、抑郁自评量表（SDS）］、生活质量［健康调查量表36（SF-36）］。采用t检验、χ²检验。结果　观察组术后1周DVT发生率低于对照组［2.50%（1/40）比20.00%（8/40）］，差异有统计学意义（χ²=4.507，P=0.034）。观察组首次下床时间（25.18±2.32）h、肠鸣音恢复时间（17.59±1.66）h、胸管留置时间（4.02±0.51）d、住院时间（11.05±1.21）d均短于对照组［（39.15±3.72）d、（19.89±1.87）h、（7.64±0.87）d、（13.49±1.28）d］，差异均有统计学意义（t=20.153、5.817、22.703、8.761，均P<0.001）。护理后，两组SAS、SDS评分均下降，SF-36评分均提高（均P<0.05）；且观察组的SAS、SDS评分均低于对照组［（45.12±4.52）分比（49.58±4.96）分、（46.09±4.62）分比（50.19±5.11）分］，SF-36评分高于对照组［（75.71±7.58）分比（62.06±6.25）分］，差异均有统计学意义（t=4.203、3.764、8.787，均P<0.001）。结论　整体护理模式可有效降低胸外科术后患者DVT的发生率，缩短术后恢复时间，缓解患者的负面情绪，进而提高其生活质量，可为今后胸外科手术患者护理方案的拟定提供参考。

关键词:

深静脉血栓形成, 胸外科手术, 整体护理, 生活质量

Abstract:

Objective　To investigate the preventive effect of holistic nursing mode for deep vein thrombosis (DVT) in postoperative thoracic surgery patients. Methods　A total of 80 thoracic surgery patients admitted to Fuzhou First People's Hospital from January 2021 to June 2023 were prospectively enrolled and were divided into a control group and an observation group according to the random number table method, with 40 cases in each group. In the control group, there were 25 males and 15 females; the age was (57.39±4.84) years old; the disease types were lung cancer in 22 cases, esophageal cancer in 14 cases, and lung benign lesions in 4 cases; the types of surgery were thoracoscopic lobectomy in 17 cases, pulmonary wedge resection in 5 cases, pleural biopsy fixation in 4 cases, and esophagectomy in 14 cases. There were 24 males and 16 females in the observation group; the age was (57.35±4.82) years old; the disease types were lung cancer in 21 cases, esophageal cancer in 14 cases, and lung benign lesions in 5 cases; the types of surgery were thoracoscopic lobectomy in 17 cases, pulmonary wedge resection in 4 cases, pleural biopsy fixation in 5 cases, and esophagectomy in 14 cases. The control group received routine nursing, and the observation group received holistic nursing intervention for 1 week. The incidence of postoperative DVT, postoperative recovery time, psychological status [Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)], and quality of life [36-item Short-Form Health Survey (SF-36)] were compared between the two groups. t test and χ² test were used. Results　The incidence of DVT in the observation group within 1 week after surgery was lower than that in the control group [2.50% (1/40) vs. 20.00% (8/40)], with a statistically significant difference (χ²=4.507, P=0.034). The first time of getting out of bed [(25.18±2.32) h], the recovery time of bowel sound [(17.59±1.66) h], the indentation time of chest tube [(4.02±0.51) d], and the length of hospital stay [(11.05±1.21) d] in the observation group were shorter than those in the control group [(39.15±3.72) d, (19.89±1.87) h, (7.64±0.87) d, and (13.49±1.28) d], with statistically significant differences (t=20.153, 5.817, 22.703, and 8.761, all P<0.001). After nursing, the SAS and SDS scores decreased, the SF-36 score increased in both groups (all P<0.05); the scores of SAS and SDS in the observation group were lower than those in the control group [(45.12±4.52) points vs. (49.58±4.96) points, (46.09±4.62) points vs. (50.19±5.11) points], and the score of SF-36 was higher than that in the control group [(75.71±7.58) points vs. (62.06±6.25) points], with statistically significant differences (t=4.203, 3.764, and 8.787, all P<0.001). Conclusions　Holistic nursing mode can effectively reduce the incidence of DVT in patients after thoracic surgery, shorten the patients' postoperative recovery time, relieve their negative emotions, and improve their quality of life. It can provide reference for the formulation of nursing plan for thoracic surgery patients in the future.

Key words:

Deep vein thrombosis, Thoracic surgery, Holistic nursing model, Quality of life

张淑芳刘会英吴燕.

整体护理模式预防胸外科术后深静脉血栓形成的应用效果 [J]. 国际医药卫生导报, 2024, 30(18): 3154-3158.

Zhang Shufang, Liu Huiying, Wu Yan.

Application effect of holistic nursing model in prevention of deep vein thrombosis after thoracic surgery [J]. International Medicine and Health Guidance News, 2024, 30(18): 3154-3158.

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