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：

靜脈血栓; 分級護理; 預防; 肺栓塞; 風險評估

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目的　探討圍手術期患者靜脈血栓預防的分級護理方法，為靜脈血栓的預防提供實證依據。方法　2009年5月－2012年1月，以某市級乙等綜合性醫院各科室手術患者為對象，引入量化工具評估患者圍手術期靜脈血栓發生的危險，并根據評估結果采取分級護理方法進行防治，并在患者出院時用彩色多普勒超聲判斷是否存在靜脈血栓，以驗證分級護理防治效果。結果　納入的318患者經評估均存在發生靜脈血栓的風險，其中低度危險患者65例，中度182例，高度危險71例。經分級護理治療，出院時均未發生靜脈血栓癥狀、肺栓塞。結論　分級護理方法安全、簡便，可操作性強，便于圍手術期患者靜脈血栓的早期、普遍預防，值得推廣。

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

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.
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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.
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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.
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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.	邱貴興, 戴尅戎, 楊慶銘, 等. 預防骨科大手術后深靜脈血栓形成的專家建議——深靜脈血栓形成預防座談會紀要[J]. 中華骨科雜志, 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.	潘曉云, 倪信樂, 謝強麗. 醫用彈力襪預防開胸術后下肢深靜脈血栓形成的效果觀察[J]. 護士進修雜志, 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.	羅勤, 鈴木. 86例圍手術期患者預防靜脈血栓癥的護理[J]. 中華護理雜志, 2008, 43(5): 411-422.
26.	于崢嶸, 李淳德, 邑曉東, 等. 脊柱手術后靜脈血栓栓塞的預防[J]. 北京大學學報醫學版, 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. 　邱貴興, 戴尅戎, 楊慶銘, 等. 預防骨科大手術后深靜脈血栓形成的專家建議——深靜脈血栓形成預防座談會紀要[J]. 中華骨科雜志, 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. 　潘曉云, 倪信樂, 謝強麗. 醫用彈力襪預防開胸術后下肢深靜脈血栓形成的效果觀察[J]. 護士進修雜志, 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. 　羅勤, 鈴木. 86例圍手術期患者預防靜脈血栓癥的護理[J]. 中華護理雜志, 2008, 43(5): 411-422.
26. 　于崢嶸, 李淳德, 邑曉東, 等. 脊柱手術后靜脈血栓栓塞的預防[J]. 北京大學學報醫學版, 2011, 4(5): 661-665.

West China Medical Journal

Research on Grading Nursing in Preventing Venous Thrombosis for Perioperative Patients

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