下肢骨折手術(shù)圍手術(shù)期深靜脈血栓形成的預(yù)防與護(hù)理探討

吳麗芬

【摘要】 目的：觀察分析下肢骨折手術(shù)圍手術(shù)期深靜脈血栓形成的預(yù)防與護(hù)理方法。方法：將在筆者所在醫(yī)院關(guān)節(jié)外科2016年6月-2018年12月收治的股骨頸骨折患者60例作為研究對(duì)象，隨機(jī)分成對(duì)照組（30例）與護(hù)理組（30例），其中對(duì)照組采取常規(guī)圍手術(shù)期護(hù)理干預(yù)，護(hù)理組采取綜合性護(hù)理干預(yù)。對(duì)照兩組患者護(hù)理前后下肢血流速度，下肢腫脹、深靜脈血栓、肺栓塞發(fā)生率，并根據(jù)結(jié)果總結(jié)圍手術(shù)期深靜脈血栓形成的預(yù)防與護(hù)理方法。結(jié)果：護(hù)理組與對(duì)照組患者護(hù)理后下肢腫脹率（6.67% vs 43.33%）、深靜脈血栓形成率（0 vs 23.33%）、肺栓塞率（0 vs 13.33%）比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。護(hù)理干預(yù)前，兩組患者下肢血流速度差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。經(jīng)護(hù)理干預(yù)后，護(hù)理組患者下肢血流速度明顯高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.001）。結(jié)論：在骨科下肢骨折圍手術(shù)期患者的護(hù)理中，術(shù)前正確評(píng)估患者危險(xiǎn)系數(shù)，進(jìn)行針對(duì)性的干預(yù)，術(shù)中注意保護(hù)患肢盡量配合醫(yī)生縮短手術(shù)時(shí)間，術(shù)后密切觀察，采取物理、康復(fù)等方法進(jìn)行干預(yù)，可減少深靜脈血栓的發(fā)生。

【關(guān)鍵詞】 下肢骨折; 圍手術(shù)期; 深靜脈血栓; 預(yù)防與護(hù)理

doi：10.14033/j.cnki.cfmr.2019.18.047 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2019）18-0-02

【Abstract】 Objective：To observe the prevention and nursing methods of deep venous thrombosis during the perioperative period of lower limb fracture surgery in orthopaedics department.Method：A total of 60 patients with femoral neck fracture were treated in our hospital during the period from June 2016 to December 2018.They were randomly divided into control group（30 cases） and nursing group（30 cases）.The control group received routine perioperative nursing intervention，while the nursing group received comprehensive nursing intervention.The blood flow velocity of lower limbs，the incidence of lower limb swelling，deep venous thrombosis and pulmonary embolism were compared between the two groups before and after nursing.The prevention and nursing methods of deep venous thrombosis during perioperative period were summarized according to the results.Result：The lower limb swelling rate（6.67% vs 43.33%），deep venous thrombosis rate（0 vs 23.33%） and pulmonary embolism rate（0 vs 13.33%） were significantly different between the nursing group and the control group （P<0.05）.Before nursing intervention，there was no significant difference in lower limb blood flow velocity between the two groups（P>0.05）.After nursing intervention，the blood flow velocity of lower limbs in nursing group was significantly higher than that in control group（P<0.001）.Conclusion：In the perioperative nursing of patients with lower limb fracture，the risk factors of patients should be correctly evaluated before operation and targeted interventions should be carried out.During operation，attention should be paid to protecting the affected limbs as much as possible to cooperate with doctors to shorten the operation time.After operation，close observation should be made，physical and rehabilitation methods should be adopted，so as to reduce the occurrence of venous thrombosis.

【Key words】 Orthopaedic lower limb fracture; Perioperative period; Deep vein thrombosis; Prevention and nursing

綜上所述，在骨科下肢骨折圍手術(shù)期患者的護(hù)理中，術(shù)前正確評(píng)估患者危險(xiǎn)系數(shù)，進(jìn)行針對(duì)性的干預(yù)，術(shù)中注意保護(hù)患肢盡量配合醫(yī)生縮短手術(shù)時(shí)間，術(shù)后密切觀察，采取物理、康復(fù)等方法進(jìn)行干預(yù)，發(fā)揮深靜脈血栓形成的綜合性預(yù)防護(hù)理干預(yù)，減少深靜脈血栓的發(fā)生。

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（收稿日期：2019-02-13） （本文編輯：張亮亮）