目的 探讨基于医联体框架下的静脉血栓栓塞症(venous thromboembolism,VTE)护理风险管理效果.方法 选取 2019 年 1 月—2022 年 1 月福建省泉州市第一医院完成骨折手术的 86 例患者作为研究对象,采用随机信封法(按照1∶1 比例)将研究对象分为医联体组与对照组,各 43 例.对照组在术后实施常规预防护理,医联体组实施常规预防护理及基于医联体框架下的VTE护理风险管理,两组护理观察时间均为 14 d.比较两组VTE发生率、疼痛评分、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)与纤维蛋白降解产物(fibrin degradation products,FDP)变化以及护理满意度.结果 在护理期间,医联体组的VTE发生率为 2.33%,低于对照组的 16.28%(P<0.05).医联体组护理在第 1、3、5、7 天的视觉模拟疼痛评分法(visual analogue scale,VAS)低于对照组(P<0.05).在凝血指标上,两组在护理 14 d后的APTT水平高于护理前(P<0.05),FDP水平低于护理前(P<0.05);两组护理后的凝血指标比较,差异有统计学意义(P<0.05).医联体组总满意度为 100%,高于对照组的 88.37%(P<0.05).结论 基于医联体框架下的VTE护理风险管理能有效降低VTE发生率,还可改善患者的凝血功能,缓解患者的疼痛水平.
Objective To explore and analyze the effect of nursing risk management of venous thromboembolism(VTE)based on the medical alliance framework.Methods A total of 86 patients who completed fracture surgery in Quanzhou First Hospital,Fujian were selected as the research subjects from January 2019 to January 2022,and the patients were randomly divided into the medical alliance group and the control group with 43 cases by random envelope method(according to a 1:1 ratio).The control group was given routine nursing after operation,and the medical alliance group was given VTE nursing risk management under the framework of medical consortium based on routine nursing of the control group.The observation time of the two groups was 14 days.The incidence of VTE,pain score,changes in activated partial thromboplastin time(APTT)and fibrin degradation products(FDP),and nursing satisfaction were compared between the two groups.Results The incidence of VTE during nursing in the medical alliance group was 2.33%,which was lower than 16.28%in the control group(P<0.05).The visual analogue scale(VAS)of the medical alliance group was lower than that of the control group at the 1st,3rd,5th and 7th day of nursing(P<0.05).The levels of APTT after nursing in the two groups were higher than those before nursing(P<0.05),and the levels of FDP were lower than those before nursing(P<0.05).The differences between the medical alliance group and the control group were statistically significant(P<0.05).The total satisfaction rate of nursing care in the medical alliance group was 100%,which was significantly higher than that in the control group(88.37%)(P<0.05).Conclusion Nursing risk management of VTE based on the medical alliance framework could effectively reduce the incidence of VTE,and improve the coagulation function of patients,and was effective in relief of patients'pain.