佟昕 姜桂春

【摘要】 深静脉血栓（deep vein thrombosis，DVT）是指血液在深静脉内不正常地凝结、阻塞管腔导致的静脉回流障碍性疾病，多发生于下肢，血栓脱落可引起肺动脉栓塞（pulmonary embolism，PE）。DVT患者中有50%的静脉血栓于术中开始形成，而由于DVT形成的临床特殊性，医护人员多重视术后血栓的预防和观察护理，忽略对手术患者的术中干预。根据国内外对术中预防DVT的重视，本文对术中DVT形成原因、风险评估及相关指南、预防DVT护理措施做了系统介绍，为使医护人员意识到术中预防DVT的重要性，完善对DVT高危患者的评估，建立术中行之有效的护理干预措施提供了理论依据。

【關键词】 深静脉血栓 下肢 护理 预防

Advances in Nursing Research on Prevention of Deep Vein Thrombosis of Lower Limb during Operation/TONG Xin， JIANG Guichun. //Medical Innovation of China， 2020， 17（11）： -172

[Abstract] Deep vein thrombosis （DVT） refers to venous reflux disorders caused by abnormal clotting of blood in the deep veins and obstruction of the lumen， which mostly occurs in the lower limbs， pulmonary embolism （PE） can occur due to thrombotic shedding. 50% of DVT patients begin to form venous thrombosis during the operation， due to the clinical specificity of DVT formation， medical staff pays more attention to the prevention and observation of postoperative thrombosis， and ignores the intraoperative intervention on the patients. According to the importance of DVT during surgery at home and abroad， this article provides a systematic introduction to the causes of DVT during surgery， risk assessment and related guidelines， and preventive measures for DVT， the evaluation of high-risk patients with DVT and the establishment of effective nursing interventions during surgery provide a theoretical basis.

[Key words] Deep vein thrombosis Lower extremity Nursing Prevention

First-authors address： Liaoning University of Traditional Chinese Medicine， Shenyang 110000， China

doi：10.3969/j.issn.1674-4985.2020.11.042

深静脉血栓（deep vein thrombosis，DVT）是指血液在深静脉内不正常地凝结、阻塞管腔导致的静脉回流障碍性疾病，多发生于下肢，具有高发病率、高致残率和易反复的特点，其临床表现比较隐匿，易被漏诊和误诊[1]。目前国内报道的外科术后DVT的发生率约为26%，而DVT患者早期死亡率则高达2%～5%。血栓一旦形成，严重影响患者的康复，甚至危及患者生命。有研究指出，有50%的静脉血栓于术中开始形成，而由于DVT形成的临床特殊性，医护人员多重视术后血栓的预防和观察护理，而忽略对手术患者的术中干预[2]。有研究显示，术中尽早采取正确的护理干预措施可有效降低患者术后形成DVT的风险[3-4]。手术室护士作为术中护理操作人员，对DVT的预防发挥着不可忽视的作用。因此，本文对下肢深静脉血栓术中护理的研究进展进行综述，旨在为手术中合理预防患者下肢DVT的形成和提高术中护理质量提供帮助。……