护理干预对骨科术后下肢深静脉血栓形成的影响

护理干预对骨科术后下肢深静脉血栓形成的影响(论文10000字)
摘    要
目的：探讨护理干预对骨科术后下肢深静脉血栓形成的影响，以为临床预防骨科术后下肢深静脉血栓形成提供有效策略。
方法：对2014年4月—2014年10月我院收治的54例骨科手术患者实施常规护理，将其设置为对照组，对2014年12月—2015年7月我院收治的60例骨科手术患者实施一系列优化的护理干预措施，将其设置为观察组，观察两组患者住院期间下肢肿胀、下肢深静脉血栓、肺栓塞发生情况，依照Doppler测算两组患者股静脉血流速度、腘静脉血流速度，并在患者出院当日采用冯志英等拟定的护理质量调查量表（工作能力、服务态度和主动性、关爱与沟通、健康教育、病区管理）对患者进行护理满意度调查，此外对两组患者住院时间以及住院费用进行比较。
结果：观察组、对照组患者护理后2周股静脉血流速度分别为（26.81±5.62）cm/s、（20.99±4.72）cm/s，腘静脉血流速度分别为（19.84±5.13）cm/s、（15.87±4.17）cm/s，护理后4周股静脉血流速度分别为（26.53±6.04）cm/s、（21.76±4.42）cm/s，腘静脉血流速度分别为（20.46±5.33）cm/s、（15.71±3.53）cm/s，两组比较差异明显具有统计学意义（P<0.05）；观察组患者发生下肢肿胀10%（6/60），下肢深静脉血栓5%（3/60），肺栓塞0%（0/60），对照组患者发生下肢肿胀18.52%（10/54），下肢深静脉血栓11.11%（6/54），肺栓塞3.70%（2/54），两组下肢肿胀、下肢深静脉血栓发生率比较差异明显具有统计学意义（P<0.05）；观察组患者护理满意度明显高于对照组，比较差异明显具有统计学意义（P<0.05）；观察组住院时间以及住院费用明显低于对照组，比较差异明显具有统计学意义（P<0.05）。

    结论：对骨科手术患者术后实施护理干预极有必要，可有效降低患者下肢深静脉血栓发生率，提高患者满意度，促进护患关系和谐发展，缩短住院时间，减小住院费用，极具临床应用价值。
关键词：护理干预； 骨科手术； 下肢深静脉血栓

ABSTRACT
   Objective：To explore the influence of nursing intervention on the formation of deep venous thrombosis in lower extremity after orthopedic surgery, and to provide effective strategy for preventing deep venous thrombosis in lower extremity after operation.
   Methods：54 cases surgical patients of orthopedics operation in our hospital from October 2014 to April 2014 were treated with routine nursing, and they were set up as the control group；60 cases surgical patients of orthopedics operation in our hospital from July 2015 to December 2014 were treated with nursing intervention,and they were set up as the observation group.Observe the incidence of lower limb swelling, lower limb deep vein thrombosis,and pulmonary embolism of two groups’ patients during hospitalization.Measure femoral vein blood flow velocity and popliteal vein blood flow velocity of two groups’ patients in accordance with the Doppler.Conduct a nursing satisfaction survey by Nursing Quality Questionnaire（working ability, service attitude and initiative, care and communication, health education, ward management）designed by Feng Zhiying when patients were discharged from the hospital.In addition，compare the two groups’ hospitalization time and hospitalization expenses. [资料来源：www.doc163.com]
   Result：After two weeks of nursing，the observation group and the control group patients’ femoral vein blood flow velocity were respectively (26.81±5.62) cm / s, (20.99±4.72) cm / s, popliteal vein blood speed respectively (1.984±5.13) cm / s, (15.87±4.17 cm / s).After four weeks of nursing, the observation group and the control group patients’ femoral vein blood flow velocity were respectively(26.53±6.04) cm / s, (21.76±4.42) cm / s, popliteal vein blood speed respectively (20.46±5.33 ) cm / s, (15.71±3.53）cm/s, the difference between the two groups has obvious statistical significance (P < 0.05)；The observation group had 10% (6/60) with swelling of lower limbs, 5% (3/60) with deep venous thrombosis of lower extremity and 0% (0/60) with pulmonary embolism.The control group had 18.52% (10/54) with swelling of lower limbs, 11.11% (6/54) with deep venous thrombosis of lower extremity and 3.70% (2/54) with pulmonary embolism，the difference between the two groups has obvious statistical significance (P < 0.05);The nursing satisfaction in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05);The hospitalization time and hospitalization expenses in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05). [资料来源：http://www.doc163.com]
   Conclusion：It is necessary to carry out nursing intervention for patients after operation in Department of orthopedics, which can reduce the incidence of deep venous thrombosis, improve patient satisfaction, promote the harmonious development between nurses and patients, shorten hospitalization time and reduce the cost of hospitalization.

KEY WORDS: Nursing intervention;Department of orthopedic operation; Deep venous thrombosis of lower extremity

TYPE OF THESIS: Research report

目  录
1.前言    1
1.1背景及意义    1
1.2研究目的及目标    2
1.3关键词定义:    2
2.研究方法    3
2.1研究设计    3
2.2研究对象    3
2.3研究工具/方法    4
2.3.1干预方法    4
2.3.2测评指标    8
2.4研究步骤    8
2.5资料分析    9

[来源：http://www.doc163.com]

3.结果    10
3.1护理前后两组患者股静脉血流速度、腘静脉血流速度比较    10
3.2两组患者住院期间并发症发生情况    10
3.3两组患者护理满意度调查结果比较    11
3.4两组患者住院时间以及住院费用比较    11
4.讨论    13
4.1 DVT发病机制    13
4.2 DVT的防御与护理    13
5.结论    17
致谢    18
参考文献    19