张佳佳 赵景荣 张小弟

[摘要] 目的 探究与分析循证护理干预对预防多发伤后患者术后深静脉血栓的效果。 方法 选取2015年6月～2017年6月陕西省咸阳市核工业215医院收治的90例多发伤患者，采取随机数字表法分为对照组与观察组，每组各45例。对照组给予常规护理，观察组在对照组基础上给予循证护理干预，比较两组患者术后下肢肿痛、腓肠肌压痛及深静脉血栓的发生率，治疗后Porter评分及患者护理满意度。 结果 术后，观察组下肢肿痛、腓肠肌压痛及深静脉血栓的发生率明显均低于对照组，差异有统计学意义（P < 0.05）。治疗后，两组Porter评分均低于术前，且观察组低于对照组，差异有统计学意义（P < 0.05）。观察组护理满意率明显高于对照组，差异有统计学意义（P < 0.05）。 结论 循证护理干预相比于常规护理能够有效预防多发伤后术后深静脉血栓的发生率，提高护理满意度。

[关键词] 循证护理干预；多发伤；深静脉血栓

[中图分类号] R473.6 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0168-04

[Abstract] Objective To explore and analyze the effect of evidence-based nursing intervention on postoperative deep vein thrombosis in patients with multiple trauma. Methods From June 2015 to June 2017， in Nuclear Industry 215 Hospital， 90 patients with multiple traumatic injuries were selected， according to random number table method， they were divided into control group and observation group， with 45 cases in each group. The control group was given routine nursing， and the observation group was given evidence-based nursing intervention based on the control group， the incidence of postoperative lower extremity swelling， tenderness， and deep venous thrombosis after operation， Porter score and patient satisfaction after treatment in two groups were compared. Results After operatiom， the incidence of lower extremity swelling， tenderness of gastrocnemius， and the deep venous thrombosis in the observation group were lower than those in the control group， the differences were statistically significant （P < 0.05）. After treatment， the Porter scores in the two groups were lower than before treatment， and this in observation group was lower than control group， the differences were statistically significant （P < 0.05）. The nursing satisfaction of the observation group was significantly higher than that of the control group， the difference was statistically significant （P < 0.05）. Conclusion Evidence-based nursing intervention can effectively prevent postoperative deep venous thrombosis and improve nursing satisfaction compared with routine nursing.

[Key words] Evidence-based nursing intervention； Multiple injuries； Deep venous thrombosis

下肢深静脉血栓形成主要是指血液在深静脉腔内出现了不正常凝结的情况，通常发生在创伤或者术后，此种异常的凝结不仅对静脉腔造成了阻塞，同时也可导致静脉回流出现障碍，一旦发生肺栓塞后能够引起严重的后果[1]。据调查研究资料显示，全身主干静脉均可以发生血栓这类疾病，且以下肢发病率最高，较为常见[2]。结合以往临床资料发现，多发伤术后深静脉血栓的形成离不开血液高凝状态、血管壁损伤及血流淤滞等条件，且由于疾病的病情较重，卧床时间较长，这也为多发伤术后深静脉血栓的形成创造了条件。因此，现临床工作中已经开始将静脉血栓症作为保证患者医疗安全优先考虑的重点，且随着医疗技术的不断改进，绝大多数的临床工作者发现下肢深静脉血栓是可以通过采取积极有效的护理方法进行预防的[3]。……