摘要
目的探讨"5A"护理模式预防结直肠癌手术患者下肢深静脉血栓形成(DVT)的临床效果。方法以2016年1月至2017年2月我院收治的80例结直肠癌手术患者为对象,盲法随机分为对照组(术后实施常规护理干预,n=42)和研究组(术后实施"5A"护理干预,n=38),观察护理干预后两组凝血功能指标[活化部分凝血活酶时间(aPTT)、纤维蛋白原(Fbg)、凝血酶原时间(PT)、D二聚体(D-D)]、住院时间、术后进食时间、下床活动时间、预防DVT的临床疗效及生存质量[生存质量测定量表(WHOQOL-BREF)]。结果护理干预前两组aPTT、Fbg、PT、D-D、WHOQOL-BREF评分相较无明显差异(P>0.05);与护理干预前相较,护理干预后研究组aPTT、PT上调,Fbg、D-D下调,患者从高凝状态向低凝状态转化;研究组住院时间、术后进食时间、下床活动时间较对照组明显短(P<0.05);研究组预防DVT的临床总有效率92.11%明显高于对照组71.43%(P<0.05);与护理干预前相较,护理干预后两组WHOQOL-BREF评分明显升高,但研究组升高幅度明显大于对照组(P<0.05)。结论"5A"护理干预在结直肠癌患者术后DVT预防中效果明显,可有效调节患者凝血功能,缩短康复时间,改善患者术后生活质量。
Objective To investigate the clinical effect of 5 A nursing model in the prevention of lower limb deep venous thrombosis(DVT)in patients undergoing colorectal cancer surgery.Methods A total of 80 patients with colorectal cancer who underwent surgery in our hospital during the period from January 2016 to February 2017 were selected as the subjects,and they were randomly divided into the control group(given routine nursing intervention after surgery,n=42)and the study group(given 5 A nursing intervention after surgery,n=38).Indexes of blood coagulation[activated partial thromboplastin time(aPTT),fibrinogen(Fbg),prothrombin time(PT),D-dimer(D-D)],length of hospital stay,time of taking food after surgery,ambulation time,clinical effect in the prevention of DVT and quality of life[the World Health Organization Quality of Life scale(WHOQOL-BREF)].Results There was no significant difference in aPTT,Fbg,PT,D-D and WHOQOL-BREF scores between the two groups before nursing intervention(P>0.05).After nursing intervention,the aPTT、PT of study group was up-regulated and Fbg、D-D was down-regulated,and the patients changed from hypercoagulable state to low coagulable state.(P<0.05).The length of hospital stay,time of taking food after surgery and ambulation time of the study group were shorter than those of the control group(P<0.05).The total effective rate of prevention of DVT in the study group was significantly higher than that in the control group(92.11%vs 71.43%)(P<0.05).After the nursing intervention,the WHOQOL-BREF scores of the two groups were increased significantly,but the increase in the study group was significantly greater than that in the control group(P<0.05).Conclusion"5 A"nursing intervention was effective in the prevention of postoperative DVT in patients with colorectal cancer.It could effectively regulate the coagulation function of patients,shorten the time of rehabilitation and improve the quality of life of patients after operation.
作者
陈丽
李智慧
张凌
杨琳
CHEN Li;LI Zhi-hui;ZHANG Ling;YANG Lin(The people's Hospital of Ya'an city,Ya'an,625000,China)
出处
《血栓与止血学》
2019年第1期129-131,134,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
结直肠癌
深静脉血栓形成
“5A”护理
Colorectal cancer
Deep venous thrombosis
5A nursing
Clinical effect
