摘要
目的 探讨集束化干预在预防连续性血液净化重症患者下肢深静脉血栓的效果.方法 选择2021年1月至2023年6月我院ICU收治的66例进行连续性血液净化治疗的重症患者作为研究对象,将患者按照护理方式的不同分为常规组和集束化干预组,每组33例.常规组给予常规护理干预,集束化干预组实施集束化护理干预,比较两组患者的并发症发生情况、血流动力学指标、焦虑和抑郁评分以及凝血指标.结果 常规组的并发症发生率为24.24％,集束化干预组的并发症发生率为3.03％,两组比较差异有统计学意义(P＜0.05).干预前,两组患者的血流峰速度(Vp)、血流平均速度(Va)和血流量(Bf)指标比较,差异均无统计学意义(均P＞0.05);干预后,两组患者的Vp、Va和Bf指标均较干预前明显加快,集束化干预组的Vp、Va和Bf指标均较常规组加快,差异均有统计学意义(均P＜0.05).干预前,两组患者的汉密尔顿焦虑量表(HA-MA)、汉密尔顿抑郁量表(HAMD)评分比较,差异均无统计学意义(均P＞0.05);干预后,两组患者的HAMA、HAMD评分均较干预前下降,集束化干预组的HAMA、HAMD评分低于常规组,差异均有统计学意义(均P＜0.05).干预前,两组患者的凝血酶原时间(PT)、凝血酶时间(TT)及活化部分凝血活酶时间(APTT)比较,差异均无统计学意义(均P＞0.05);干预后,常规组的PT、TT与APTT均无明显降低,集束化干预组的PT、TT及APTT均显著降低,组间比较差异均有统计学意义(均P＜0.05).结论 集束化干预可降低连续性血液净化重症患者下肢深静脉血栓的发生率,提高治疗效果,值得推广使用.
Abstract
Objective To explore the clinical application of continuous blood purification in the prevention of lower extremity deep venous thrombosis in critically ill patients.Methods A total of 66 severe patients who needed continuous blood purification treat-ment in ICU of Guangxi International Zhuang Medical Hospital from January 2021 to June 2023 were selected as the research objects.66 patients were divided into a conventional group and a bundled intervention group according to different nursing methods,with 33 peo-ple in each group.The routine group patients received routine nursing interventions,while the bundled intervention group received bun-dled nursing interventions.Compare the incidence of complications,hemodynamic indicators,anxiety and depression scores,and coagula-tion indicators between two groups of patients.Results Compared with the conventional group with a complication incidence rate of 24.24％,the bundled intervention group had a lower complication incidence rate of 3.03％,and the difference between groups was sig-nificant(P＜0.05).Before intervention,there was no difference in Vp,Va,and BF indicators between the conventional group and the bundled intervention group(all P＞0.05).After intervention,the Vp,Va,and BF indicators of patients in the conventional group and the bundled intervention group were significantly increased,and there were significant differences at different time points within the group(all P＜0.05);The Vp,Va,and BF indicators of patients in the bundled intervention group were higher than those in the conven-tional group,and there was a significant difference between the groups(all P＜0.05).Before intervention,the HAMA and HAMD scores of patients in the conventional group and the bundled intervention group were similar(all P＞0.05).After intervention,the HA-MA and HAMD scores of patients in both the conventional group and the bundled intervention group decreased,and there was a signifi-cant difference at different time points within the group(P＜0.05).The HAMA and HAMD scores of patients in the bundled interven-tion group were lower than those in the conventional group,and there was a significant difference between the groups(P＜0.05).Be-fore intervention,there was no difference in prothrombin time,thrombin time,and activated partial thrombin time between the conven-tional group and the bundled intervention group(P＞0.05).After intervention,there was no significant decrease in prothrombin time,thrombin time,and activated partial thrombin time in the conventional group of patients,while in the bundled intervention group,the prothrombin time,thrombin time,and activated partial thrombin time were all significantly reduced(all P＜0.05),and all were better than the conventional group,with significant differences between groups(all P＜0.05).Conclusion The cluster nursing interven-tion has a significant effect on reducing the incidence of lower extremity deep venous thrombosis and improving the therapeutic effect in severe patients with continuous blood purification,which is worthy of promotion and application.
维普
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