通讯作者：贺兰英，1963年1月，女，汉族，山东烟台人，现任职于烟台毓璜顶医院，副主任护师，大专。研究方向：创伤骨科护理。

摘要：目的：开展医护一体化护理，并分析其对预防老年髋部骨折术后DVT的效果。方法：选取2019年1月-2021年1月，在我院接受手术治疗的102例老年髋部骨折患者。采取随机数字表法，将其分为两组。对照组51例，应用LMWH预防;观察组51例，在此基础上，应用医护一体化护理。结果：干预后，观察组患者的Fbg、D-D水平明显低于对照组，aPTT水平明显高于对照组（P < 0.05）;观察组患者的DVT发生率为3.92%，明显低于对照组的15.69%，且护理满意率为94.12%，明显高于78.43%（P < 0.05）;干预后，观察组患者的Harris评分、生活质量评分均明显高于对照组（P < 0.05）。结论：应用医护一体化护理可改善其血液状态，降低DVT发生率，提高患者护理满意度、关节功能恢复情况及生活质量，值得推广。

关键词：髋部骨折;深静脉血栓形成;医护一体化护理

Abstract： Objective： to carry out the integration of medical and nursing care， and analyze its effect on the prevention of DVT after hip fracture surgery in the elderly. Methods： from January 2019 to January 2021， 102 elderly patients with hip fracture were selected. They were randomly divided into two groups. The control group of 51 cases， the application of LMWH prevention; the observation group of 51 cases， on this basis， the application of integrated care. Results： after the intervention， the FBG and D-D levels of the observation group were significantly lower than those of the control group， and the aPTT level was significantly higher than that of the control group （P < 0.05）; The incidence of DVT in the observation group was 3.92%， which was significantly lower than 15.69% in the control group， and the nursing satisfaction rate was 94.12%， which was significantly higher than 78.43% （P < 0.05）; After the intervention， Harris score and quality of life score of the observation group were significantly higher than those of the control group （P < 0.05）. Conclusion： the application of medical care integration nursing can improve the blood state， reduce the incidence of DVT， improve the patient’s nursing satisfaction， joint function recovery and quality of life， which is worthy of promotion.

Keywords： Hip fracture; deep venous thrombosis; integration of medical and nursing care

一、前言

髋部骨折的发生主要与骨质疏松有关，多见于老年人群，而静脉血栓栓塞（VTE）为老年髋部骨折术后最常见的并发症之一[1]。2015年，国际血栓与止血学会、世界血栓专家委员会已将VTE列为特殊致死病因。根据美国胸科医师学会建议，为预防（DVT）发生建议对患者采取皮下注射低分子肝素（LMWH）治疗，尽管如此，患者术前下肢DVT发生率仍为2.6%～17.3%[2]，由于是骨折48 h后未手术患者，其术前下肢DVT发生率可达到54%～62%。由此可见，如何有效预防VTE仍是临床亟待解决的重要问题。根据《骨科静脉血栓预防及护理中国专家共识》倡议，为提高骨科VTE防治效果，应建立规范化、科学化的医护管理体系[3]。……