老年腹部创伤患者术后深静脉血栓高危风险的筛查及护理

摘要

Objective To screen the elderly patients with high risk of postoperative deep venous thrombosis(DVT) by thrombelastography(TEG) combined with DVT risk factors assessment form,and to provide targeted interventions to prevent postoperative DVT.Methods Totally 200 elderly patients in General Surgery for elective surgery were recruited in this study.The patients were assessed by using the DVT risk factors assessment form within 24 hours of hospitalization.The patients with a score ≥3 were screened by TEG for coagulation abnormalities and received targeted graded interventions.The coagulation reaction time and maximum amplitude value were compared before and after intervention.The incidence of DVT was recorded.Results Sixty-one patients were rated a score≥3 and 16 cases were identified as hypercoagulable patients by TEG.The results were improved by graded interventions and no DVT occurred.Conclusion Using TEG combined with DVT risk factor assessment form to screen the high risk elderly patients and developing graded interventions can effectively prevent postoperative DVT.%目的 采用血栓弹力图(Thrombelastography,TEG)联合深静脉血栓风险因素评估表,筛查深静脉血栓高危风险的老年术后患者,进行针对性的医疗护理干预,以减少和预防术后深静脉血栓的发生.方法 选取2010年12月至2011年12月入住普外科择期手术的老年患者200例,入院24h内采用深静脉血栓风险因素评估表进行评估,对于评分≥3分的高危风险患者,给予TEG监测,筛查出凝血功能异常患者,进行分级干预,观察干预前、后凝血反应时间(R)、血小板和纤维蛋白原指标等变化,统计深静脉血栓的发生率.结果 200例老年患者中,深静脉血栓风险因素评分≥3分的61例,其中共筛查出高凝患者16例.经分级干预后,患者各项指标均好转,未发生深静脉血栓.结论 采用血栓弹力图联合深静脉血栓风险因素评估表筛查择期手术的老年高凝患者,并行分级干预措施,能有效预防术后深静脉血栓的发生.