低分子肝素钠集束化护理预防危重症患者深静脉血栓的临床药学研究

摘要

本研究旨在探讨低分子肝素钠联合集束化护理对预防危重症患者形成深静脉血栓(DVT)的临床效果及应用价值.选取2012~2014年我院收治危重症患者109例，随机分为两组，对照组(n=53)给予常规护理治疗，试验组(n=56)在常规护理治疗基础上采用集束化护理措施.检测两组患者在治疗后7天的血清D-二聚体水平、并行深静脉彩超检查.比较两组患者的住ICU时间、治愈出院的比例以及住院期间病情恶化发生率.结果显示，试验组仅1例患者出现股静脉血流滞缓，无一例发生深静脉血栓，明显优于对照组(P<0.05).试验组的平均住ICU时间以及病情恶化发生率均低于对照组，且治愈出院的比例(85.71%)高于对照组(66.04%)，差异具有统计学意义(P<0.05).两组患者住院期间均未出现不良反应.因此，集束化护理联合低分子肝素钠可有效预防深静脉血栓的形成，可缩短住 ICU 时间，提高治愈出院比例，且安全性较高，值得临床进一步研究和应用.%The obj ective of this clinical pharmacy study is to investigate the cluster therapy plus heparin applied on the deep venous thrombosis (DVT)prevention in patients who were hospitalized with severe disease.109 cases of critically ill patients from 2012 to 2014 were randomly divided into two groups,the control group (n=53)were received routine nursing care,the experimental group (n=5 6 )were treated by cluster therapy based on the routine nursing care.After one week,serum D-dimmer levels of patients were collected while the deep venous color doppler ultrasound examination were actualized.Additionally,the ICUtime,the proportion of cured patients,and the incidence of the disease during hospitalization were also compared.The result indicated that,only 1 patient′s femoral vein blood flow is slow in test group,and no deep venous thrombosis occurred,which was significantly better than the control group (P<0.05).The average ICU time in the experimental group and the incidence of the disease progression were lower than those in the control group (85.71%), and the proportion of the patients was significantly higher than that of the control group (6 6 . 04%),the difference was statistically significant (P<0.05).No severe adverse reaction oc-curred in both two groups of patients.Form all the above,we can cautiously draw a conclu-sion,the cluster therapy can effectively prevent the formation of deep venous thrombosis, shorten the time of ICU time,as well as improve the proportion of cured patients.According to the higher efficiency and safety,cluster therapy is worthy of further research and clinical pharmacy application.