预防性护理对高血压脑出血患者术后下肢深静脉血栓形成的影响

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[摘要] 目的 探讨预防性护理对高血压脑出血患者术后下肢深静脉血栓（DVT）形成的影响。 方法 将我院120例高血压脑出血患者分为观察组和对照组，每组各60例。对照组采用常规护理，观察组在对照组的基础上给予预防性护理，比较两组DVT形成情况。 结果 观察组与对照组在术后7 d的凝血指标变化比较差异无统计学意义（P > 0.05）。观察组DVT的发生率为0，显著低于对照组的15.0%（P < 0.05）。观察组的护理质量满意度为98.3%，显著高于对照组的83.3%（P < 0.05）。两组术后再出血率差异无统计学意义（P > 0.05）。 结论 预防性护理有利于减少高血压脑出血术后DVT的形成。

[关键词] 预防性护理；高血压脑出血；下肢深静脉血栓；并发症

[中图分类号] R473.6 [文献标识码] C [文章编号] 1673-7210（2012）08（b）-0138-02

The effect of prevention nursing on deep venous thrombosis of lower limb in patients with hypertensive cerebral hemorrhage

CAO Yinghua ZHAO Xiaohui WANG Yingqi

Intensive Care Unit, Bayi Neurologist Hospital Affiliated to Beijing Military Area Commands General Hospital, Beijing 100700, China

[Abstract] Objective To investigate the effect of prevention nursing on deep venous thrombosis of lower limb in patients with hypertensive cerebral hemorrhage. Methods 120 patients with hypertensive cerebral hemorrhage were divided into the observation group and the control group, each group had 60 cases. the control group was given conventional nursing, the observation group was given preventive care on the basis of the control group, two groups were compare with DVT. Results Coagulation index changes after the postoperative 7 days had no significant difference between two groups (P > 0.05). The rate of DVT was 0 in the observation group that was significantly lower than 15% in the control group (P < 0.05). Satisfaction degree on nursing quality was 98.3% in the observation group that was significantly higher than 83.3% in control group (P < 0.05), postoperative rebreeding rate in two groups was no significant difference (P > 0.05). Conclusion Preventive care helps to reduce DVT in patients with hypertensive cerebral hemorrhage.

[Key words] Preventive care; Hypertensive cerebral hemorrhage; Lower extremity deep vein thrombosis; Complications

下肢深静脉血栓（DVT）是一种静脉内血凝块阻塞性疾病，为外科常见疾病之一。DVT仅影响肢体功能，致残率较高，严重者可因血栓脱落，导致肺栓塞而增加患者的猝死率[1]。DVT也是高血压术后比较常见的并发症，严重影响患者的生存和康复。近年来，DVT越来越引起临床工作者的重视。我院2009年12月～2010年5月对60例高血压脑出血患者术后实施预防性护理，有效预防了DVT的发生，现报道如下：

1 资料与方法

1.1 一般资料

120例高血压脑出血患者，所有病例均行头颅CT检查明确出血部位，排除脑干出血及血肿累及脑干的患者，并排除严重的心、肝、肾等疾病或功能衰竭、颅内及全身感染和凝血机制障碍的患者，排除对肝素过敏者；其中，男72例，女48例；年龄43～75岁，平均（57.2±5.1）岁；发病时间5分，临床表现为突发意识不清，神志朦胧，语言不利，嗜睡，呕吐。出血部位：皮层下16例，壳核74例，丘脑24例，小脑出血6例；有42例患者出血破入脑室。出血量为35～90 mL，平均（55.8±14.2）mL。将该组患者按照治疗方法的不同分为观察组和对照组，每组60例，两组一般资料比较差异无统计学意义（P > 0.05），具有可比性。