作　　者： (刘莉慧）; (宁宁）; (侯晓玲）; (刘晓艳）; (何月）;

机构地区： 四川大学华西医院骨科,四川成都610041

出　　处： 《西部医学》 2017年第9期1255-1259,共5页

摘　　要： 目的探讨应用血栓筛查流程图预防老年髋部骨折患者深静脉血栓的效果。方法将2014年5月~2016年4月收治的290例老年髋部骨折患者分为对照组和观察组两组,每组145例。对照组实施常规血栓预防措施和常规髋部骨折治疗措施,观察组采用血栓筛查流程图,通过D-二聚体检测和RAPT(the risk assessment profile for thromboembolism)量表对患者血栓形成风险进行评估,根据D-二聚体值及RAPT评估结果按照流程图采取相应的干预措施和常规髋部骨折治疗措施,比较两组患者围手术期的深静脉血栓(Deep Vein Thrombosis,DVT)发生情况、住院患者满意度、平均住院日;通过Harris评分比较两组患者术后治疗效果。结果观察组的D-二聚体阳性率为99.63%;RAPT 5~7分,DVT发生率为0;RAPT 8~14分,DVT发生率为8.33%;RAPT>14分,DVT发生率为28.57%。观察组患者深静脉近端/远端血栓发生率低于对照组,满意度高于对照组,平均住院日少于对照组,术后疗效优良率高于对照组,差异均有统计学意义(P<0.05)。结论医护一体化模式下应用血栓筛查流程图能有效降低老年髋部骨折深静脉血栓发生率,可提高患者满意度,缩短平均住院日,提高术后疗效,并有利于老年髋部骨折患者疾病恢复。 Objective To study the effect of thrombosis screening flowchart for preventing deep vein thrombosis after senile hip fracture operation Methods 290 senile hip fracture operation patients were divided into control group and observation group, 145 cases in each group. Observation group were prevented deep vein thrombosis with thrombosis screening flowchart, But control group were do not. We compared the difference of incidence thrombosis, hospital patient satisfaction, the average of length of stay between the two groups by Ddimer test and RAPT score. The effect of operation was evaluated by Harris score. Results Ddimer rate, RAPT score and DVT rate of observation group were 99.63%, 5～7 and 0. RAPT score and DVT rate of control group were 8～14 and 8.33%. Compared with control group, the incidence of thrombosis of observation group was significantly reduced（P〈0.05）, the hospital satisfaction was significantly increased of observation group（P〈0.05）, the average of length of stay of observation group was short（P〈0.05）. The effect of operation of observation group was better than that of control group（P〈0.05）.Conclusion The thrombosis screening flowchart could effectively prevent deep vein thrombosis after senile hip fracture operation by healthcare and nurse integration.

关 键 词： 老年髋部骨折 血栓筛查流程图 深静脉血栓 医护一体化