何佳丽　李淑霞　蒋耀颖　匡姣　王强

【摘要】 目的：探討项目管理在预防普外科恶性肿瘤患者术后发生深静脉血栓（DVT）的应用效果。方法：分析2018年1-12月普外科恶性肿瘤手术患者（对照组，573例）发生DVT的根本原因，讨论制订对策并实施，观察2019年1-12月项目管理后普外科护士对预防DVT知识掌握情况，以及该阶段恶性肿瘤患者（观察组，627例）术后DVT发生率等护理质量指标。结果：管理后，护士预防DVT知识测验得分、风险评估率、评估正确率和护理措施落实率均显著高于管理前，差异均有统计学意义（P<0.05）;观察组患者术后DVT发生率0.3%，低于对照组的1.6%，差异有统计学意义（P=0.023）;观察组患者护理满意度评分（96.77±0.35）分，高于对照组，差异均有统计学意义（P<0.001）。结论：开展项目管理可有效提升护理质量，降低术后DVT发生率，提高患者满意度，值得在临床推广。

【关键词】 普外科 恶性肿瘤 项目管理 深静脉血栓

doi：10.14033/j.cnki.cfmr.2020.16.062 文献标识码 B 文章编号 1674-6805（2020）16-0-03

Effect of Project Management on Prevention of Postoperative Deep Vein Thrombosis in Patients with Malignant Tumor in the Department of General Surgery/HE Jiali， LI Shuxia， JIANG Yaoying， KUANG Jiao， WANG Qiang. //Chinese and Foreign Medical Research， 2020， 18（16）： -153

[Abstract] Objective： To explore the effect of project management in the prevention of deep vein thrombosis （DVT） in patients with malignant tumor in the Department of General Surgery. Method： Analyzed the root causes of DVT in patients with malignant tumor surgery from January to December 2018 （control group， 573 cases）， discussed the formulation and implementation of countermeasures. From January to December 2019， observed the mastery of DVT prevention knowledge and the incidence of postoperative DVT in patients with malignant tumors during this period （observation group， 627 cases） and other nursing quality indicators after project management. Result： After the implementation of project management， the scores of DVT knowledge test， risk assessment rate， assessment accuracy rate and implementation rate of nursing measures were significantly higher than those of before management， the differences were statistically significant （P<0.05）. The incidence of postoperative DVT in the observation group was to 0.3%， lower than 1.6% in the control group， the difference was statistically significant （P=0.023）. The satisfaction score of patients with surgery in the observation group was （96.77±0.35） points， which was higher than that in the control group， the difference was statistically significant （P<0.001）. Conclusion： Conducting project management can effectively improve the quality of nursing， reduce the incidence of postoperative DVT and improve patients satisfaction， which is worthy of clinical promotion.

[Key words] Department of General Surgery Malignant tumor Project management Deep vein thrombosis

First-authors address： Guangzhou First Peoples Hospital， Guangzhou 510180， China

深静脉血栓（deep vein thrombosis，DVT）形成是外科手术患者术后常见的并发症，不仅影响患者术后康复，延长其住院时间，严重者危及生命[1-4]。2018年笔者所在医院普外科恶性肿瘤手术患者术后DVT发生率为1.0%，科室缺乏对DVT风险的系统评估和诊疗效果评价。为降低术后DVT发生率，2019年普外科5个病区联合开展项目管理，构建并推广普外科恶性肿瘤患者术后DVT防治方案，根据项目活动的相关知识、技能、工具和技术[5]，对涉及项目的全部资源进行科学管理，从计划、实施到效果评价全程管理，有效预防了恶性肿瘤患者术后发生DVT，现报告如下。

1 资料与方法

1.1 一般资料

本研究将2018年1-12月笔者医院实施项目管理前的573例恶性肿瘤手术患者作为对照组，选择普外科5个病区2019年1-12月627例恶性肿瘤患者DVT中危及高危（Caprini评分≥3分，评分参照文献[6]）的手术患者为观察组。纳入标准：参照2016文献[7]《中国普通外科围手术期血栓预防与管理指南》的普外科恶性肿瘤患者手术，主要包括胃肠、肝胆胰脾、甲状腺和乳腺等恶性肿瘤患者;年龄≥18岁;无精神类疾病。……