“5A”护理对椎体压缩性骨折患者经皮椎体后凸成形术后下肢深静脉血栓的预防效果

Effect of "5A" nursing in prevention of deep venous thrombosis of lower extremity after percutaneous kyphoplasty in patients with vertebral compression fractures

  • 摘要:
      目的  探讨“5A”护理对椎体压缩性骨折患者经皮椎体后凸成形术(PKP)后下肢深静脉血栓(DVT)的预防效果。
      方法  选取择期行PKP治疗的椎体压缩性骨折患者200例,按随机数表法分为观察组和对照组,各100例。对照组采用常规护理,观察组在常规护理的基础上联用“5A”护理。比较2组临床疗效、DVT发生率和手术前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)变化,并比较2组的下床活动时间、住院时间、住院费用及术后并发症发生率。
      结果  观察组治疗总有效率高于对照组, DVT发生率低于对照组,差异有统计学意义(P<0.05); 2组手术前后的PT、APTT、TT、FIB比较,差异均无统计学意义(P>0.05),观察组术后D-D水平低于对照组,差异有统计学意义(P<0.05); 观察组下床活动时间早于对照组,住院时间短于对照组,住院费用少于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。
      结论  “5A”护理可有效改善椎体压缩性骨折患者PKP术后血液高凝状态,预防DVT发生,促进康复,减轻患者的病痛及经济负担。

     

    Abstract:
      Objective  To observe the effect of "5A" nursing in prevention of lower extremity deep venous thrombosis (DVT) of patients with vertebral compression fractures after percutaneous kyphoplasty (PKP).
      Methods  A total of 200 patients with vertebral compression fractures who underwent PKP surgery in our hospital were selected and divided into observation group and control group according to the random number table method, with 100 cases in each group. Control group was treated with routine nursing, and observation group was combined with "5A" nursing on the basis of routine nursing. The clinical efficacy, incidence of DVT, and changes in prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB) and D-dimer (D-D) before and after surgery were compared. Meanwhile, ambulation time, hospital stay, hospitalization costs and incidence of postoperative complications were compared between the two groups.
      Results  The total effective rate in observation group was significantly higher while the incidence rate of DVT was significantly lower than that in control group (P < 0.05). There were no significant differences in the PT, APTT, TT and FIB between the two groups before and after surgery (P>0.05). The D-D level in observation group after operation was significantly lower than that in control group (P < 0.05). The ambulation time in observation group was significantly earlier, the hospital stay was significantly shorter, the hospitalization cost was significantly less, and the incidence of postoperative complications was significantly lower than those in control group (P < 0.05).
      Conclusion  "5A" nursing can effectively improve the hypercoagulability, prevent the occurrence of DVT, promote the recovery, and reduce the pain and economic burden of patients with vertebral compression fractures after PKP.

     

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