Research on Grading Nursing in Preventing Venous Thrombosis for Perioperative Patients_West China Medical Journal

Authors：

LUO Qin ¹ , HE Wen ¹ , NING Ning ² , CHEN Zhonglan ³

1. The First People’s Hospital of Guangyuan, Guangyuan, Sichuan 6281017, P. R. China; 2. West China Nursing Department of Sichuan University, Chengdu, Sichuan 610041, P. R. China; 3. Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

静脉血栓; 分级护理; 预防; 肺栓塞; 风险评估

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目的　探讨围手术期患者静脉血栓预防的分级护理方法，为静脉血栓的预防提供实证依据。方法　2009年5月－2012年1月，以某市级乙等综合性医院各科室手术患者为对象，引入量化工具评估患者围手术期静脉血栓发生的危险，并根据评估结果采取分级护理方法进行防治，并在患者出院时用彩色多普勒超声判断是否存在静脉血栓，以验证分级护理防治效果。结果　纳入的318患者经评估均存在发生静脉血栓的风险，其中低度危险患者65例，中度182例，高度危险71例。经分级护理治疗，出院时均未发生静脉血栓症状、肺栓塞。结论　分级护理方法安全、简便，可操作性强，便于围手术期患者静脉血栓的早期、普遍预防，值得推广。

Citation： LUO Qin,HE Wen,NING Ning,CHEN Zhonglan. Research on Grading Nursing in Preventing Venous Thrombosis for Perioperative Patients. West China Medical Journal, 2012, 27(8): 1240-1243. doi: Copy

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2.	Lindblad B, Eriksson A, Bergqvist D. Autopsy-verified pulmonary embolism in a surgical department: analysis of the period from 1951 to 1988[J]. Br J Surg, 1991, 78(7): 849-852.
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6.	Douketis JD, Eikelboom JW, Quinlan DJ, et al. Short duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of prospective studies investigating symptomatic outcomes[J]. Arch Intern Med, 2002, 162(13): 1465-1471.
7.	Ibrahim EH, Iregui M, Prentice D, et al. Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis[J]. Crit Care Med, 2002, 30(4): 771-774.
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15.	Geerts WH, Heit JA, Clagett GP, et al. Prevention of venous thromboembolism[J]. Chest, 2001, 119(1 Suppl): 132S-175S.
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18.	Thromboembolic Risk Factors (THRIFT) Consensus Group. Risk of and prophylaxis for venous thromboembolism in hospital patients[J]. BMJ, 1992, 305(6853): 567-574.
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21.	邱贵兴, 戴尅戎, 杨庆铭, 等. 预防骨科大手术后深静脉血栓形成的专家建议——深静脉血栓形成预防座谈会纪要[J]. 中华骨科杂志, 2005, 25(10): 636-640.
22.	Tufano A, Coppola A, Cerbone AM, et al. Preventing postsurgical venous thromboembolism: pharmacological approaches[J]. Semin Thromb Hemost, 2011, 37(3): 252-266．.
23.	潘晓云, 倪信乐, 谢强丽. 医用弹力袜预防开胸术后下肢深静脉血栓形成的效果观察[J]. 护士进修杂志, 2009, 24(1): 46-47.
24.	Geerts WH, Pineo G, Heit J, et al. Prevention of venousthromboembolism: the 7th ACCP conference on antithromboticand thrombolytic therapy[J]. Chest, 2004, 126 (Suppl 3): 338-400.
25.	罗勤, 铃木. 86例围手术期患者预防静脉血栓症的护理[J]. 中华护理杂志, 2008, 43(5): 411-422.
26.	于峥嵘, 李淳德, 邑晓东, 等. 脊柱手术后静脉血栓栓塞的预防[J]. 北京大学学报医学版, 2011, 4(5): 661-665.

1. 　Paul AK, Sabine E. Deep vein thrombosis[J]. Lancet, 2005, 365(9445): 1163-1174.
2. 　Lindblad B, Eriksson A, Bergqvist D. Autopsy-verified pulmonary embolism in a surgical department: analysis of the period from 1951 to 1988[J]. Br J Surg, 1991, 78(7): 849-852.
3. 　Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy[J]. Chest, 1995, 108(4): 978-981.
4. 　Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis?[J]. J R Soc Med, 1989, 82(4): 203-205.
5. 　Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after totalhip or knee replacement: a meta-analysis of the randomisedtrials[J]. Lancet, 2001, 358(9275): 9-15.
6. 　Douketis JD, Eikelboom JW, Quinlan DJ, et al. Short duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of prospective studies investigating symptomatic outcomes[J]. Arch Intern Med, 2002, 162(13): 1465-1471.
7. 　Ibrahim EH, Iregui M, Prentice D, et al. Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis[J]. Crit Care Med, 2002, 30(4): 771-774.
8. 　Paiement GD, Wessinger SJ, Harris WH. Cost-effectiveness of prophylaxis in total hip replacement[J]. Am J Surg, 1991, 161(4): 519-524.
9. 　Geerts WH, Code KI, Jay RM, et al. A prospective study of venous thromboembolism after major trauma[J]. N Engl J Med, 1994, 331(24): 1601-1606.
10. 　Mismetti P, Laporte S, Darmon JY, et al. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery[J]. Br J Surg, 2001, 88(7): 913-930.
11. 　Clagett GP, Reisch JS. Prevention of venous thromboembolismin general surgical patients: results of meta-analysis[J]. Ann Surg, 1988, 208(2): 227-240.
12. 　Pezzuoli G, Neri Serneri GG, Settembrini P, et al. Prophylaxis of fatal pulmonary embolism in general surgery using low-molecular-weight heparin CY 216: a multicentre, double-blind, randomized, controlled, clinical trial versus placebo (STEP)[J]. Int Surg, 1989, 74(S1): 205-210.
13. 　Greer IA. Epidemiology, risk factors and prophylaxis of venous thrombo-embolism in obstetrics and gynaecology[J]. Baillieres Clin Obstet Gynaecol, 1997, 11(3): 403-430.
14. 　Heilmann L, von Tempelhoff GF, Schneider D. Prevention of thrombosis prophylaxis in gynecologic malignancy[J]. Clin Appl Thromb Hemost, 1998, 4(3): 153-159.
15. 　Geerts WH, Heit JA, Clagett GP, et al. Prevention of venous thromboembolism[J]. Chest, 2001, 119(1 Suppl): 132S-175S.
16. 　Crowhurst JA, Plaat F. Why mothers die--report on confidential enquiries into maternal deaths in the United Kingdom 1994-1996[J]. Anaesthesia, 1999, 54(3): 207-209.
17. 　Cipolle MD, Wojcik R, Seislove E, et al. The role of surveillance duplex scanning in preventing venous thromboembolism in trauma patients[J]. J Trauma, 2002, 52(3): 453-462.
18. 　Thromboembolic Risk Factors (THRIFT) Consensus Group. Risk of and prophylaxis for venous thromboembolism in hospital patients[J]. BMJ, 1992, 305(6853): 567-574.
19. 　Cohen A, Alikhan R, Arcelus J, et al. A risk assessment model for identifying medical patients who should receive thromboprophylaxis [abstract][J]. J Thromb Haemost, 2003, 1(Suppl): 437.
20. 　Samama MM, Dahl OE, Mismetti P, et al. Individualizing the risk of venous thromboembolism in medical and surgical patients: development of the decision matrix for VTE prophylaxis [abstract][J]. J Thromb Haemost, 2003, 1(Suppl): 436.
21. 　邱贵兴, 戴尅戎, 杨庆铭, 等. 预防骨科大手术后深静脉血栓形成的专家建议——深静脉血栓形成预防座谈会纪要[J]. 中华骨科杂志, 2005, 25(10): 636-640.
22. 　Tufano A, Coppola A, Cerbone AM, et al. Preventing postsurgical venous thromboembolism: pharmacological approaches[J]. Semin Thromb Hemost, 2011, 37(3): 252-266．.
23. 　潘晓云, 倪信乐, 谢强丽. 医用弹力袜预防开胸术后下肢深静脉血栓形成的效果观察[J]. 护士进修杂志, 2009, 24(1): 46-47.
24. 　Geerts WH, Pineo G, Heit J, et al. Prevention of venousthromboembolism: the 7th ACCP conference on antithromboticand thrombolytic therapy[J]. Chest, 2004, 126 (Suppl 3): 338-400.
25. 　罗勤, 铃木. 86例围手术期患者预防静脉血栓症的护理[J]. 中华护理杂志, 2008, 43(5): 411-422.
26. 　于峥嵘, 李淳德, 邑晓东, 等. 脊柱手术后静脉血栓栓塞的预防[J]. 北京大学学报医学版, 2011, 4(5): 661-665.

West China Medical Journal

Research on Grading Nursing in Preventing Venous Thrombosis for Perioperative Patients

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