早期康复活动在下肢深静脉血栓导管接触性溶栓术后患者中的应用研究

doi:10.3761/j.issn.0254-1769.2020.07.003

摘要/Abstract

摘要：

目的探讨早期康复活动干预在下肢深静脉血栓导管接触性溶栓术后患者中的应用效果。方法采用便利抽样,选取2018年4月—12月在苏州市某三级甲等医院住院的40例患者纳入试验组,选取2017年6月—2018年3月住院的40例患者纳入对照组。试验组接受早期康复活动干预,对照组接受常规护理。比较两组住院期间患肢髌骨上缘15 cm和髌骨下缘10 cm腿围周径、尿激酶用量、溶栓天数、舒适度评分、疼痛评分、患者对护理满意度评分、穿刺处渗血及溶栓导管移位的发生率;比较两组出院后1个月和3个月的生活质量评分及血栓形成后综合征（postthrombotic syndrome, PTS）评分。结果住院期间试验组患侧肢体髌骨下缘10 cm腿围周径差小于对照组、尿激酶用量及溶栓天数少于对照组、疼痛数字评分低于对照组,患者对护理满意度评分高于对照组,差异有统计学意义（P<0.05）;出院后1个月试验组在生理机能、生理职能、躯体疼痛、总体健康状况、情感职能、精神健康方面得分高于对照组,PTS评分低于对照组,差异有统计学意义（P<0.05）;出院3个月后试验组在生理职能、躯体疼痛、总体健康状况方面得分高于对照组,PTS评分低于对照组,差异有统计学意义（P<0.05）;组内比较试验组在出院后3个月的生理机能、精力、社会功能、情感职能方面的得分高于出院后1个月得分,PTS评分低于出院后1个月得分,差异有统计学意义（P<0.05）;对照组在出院后3个月的生活质量8个维度得分均高于出院后1个月得分,PTS评分低于出院后1个月评分,差异均有统计学意义（P<0.05）。结论为下肢深静脉血栓导管接触性溶栓治疗术后患者实施早期康复活动干预能改善患者的生活质量,提高患者的舒适度。

关键词: 静脉血栓形成, 溶栓, 生活质量, 康复, 早期活动

Abstract:

Objective To explore the effect of early rehabilitation intervention in deep venous thrombosis of lower extremity patients after catheter-directed thrombolysis. Methods 40 deep venous thrombosis of lower extremity patients admitted to hospital from June 2017 to March 2018 were enrolled in the control group with routine nursing care. Another 40 patients admitted to hospital from April 2018 to December 2018 were selected as the experimental group and received early rehabilitation nursing intervention. Upper and lower legs circumference,Urokinase dosage,thrombolysis time,comfort scores,pain scores,patient’s satisfaction,incidence of blood seepage at puncture site and catheter displacement,quality of life scores and PTS scores of patients at 1 month and 3 months after discharge were observed and compared. Results Leg circumference was significantly smaller in the experimental group than that in the control group. The thrombolysis time and Urokinase dosage were significantly lower in the experimental group than those in the control group.The patient satisfaction score in the experimental group was higher than that in the control group with statistical differences（P<0.05）. The scores of physical functioning,physical role,physical pain,general health status,emotional role and mental health at 1 month after discharge were higher in the experimental group than those in the control group. The PTS score in the experimental group was lower than that in the control group with statistical differences（P<0.05）. The scores of physical role,physical pain and general health status at 3 months after discharge were higher in the experimental group than those in the control group. The PTS score in the experimental group was lower than that in the control group. The differences were statistically significant（P<0.05）. In the control group,the scores of 8 dimensions in QOL at 3 months after discharge were higher than those at 1 month after discharge,and the PTS score was lower than it at 1 month after discharge,with statistical differences（P<0.05）.In the experimental group,the scores of physical functioning,vitality,social functioning and emotional role at 3 months after discharge were higher than those in 1 month after discharge. The PTS score was lower than it at 1 month after discharge. The differences were statistically significant（P<0.05）. Conclusion Early rehabilitation intervention of lower extremity patients after catheter-directed thrombolysis can improve the quality of life and comfort of patients with deep vein thrombosis.

Key words: Venous Thrombosis, Thrombolysis, Quality of Life, Rehabilitation, Early Activity

钱多, 王玫玲, 蒋冰歆, 赵丹. 早期康复活动在下肢深静脉血栓导管接触性溶栓术后患者中的应用研究[J]. 中华护理杂志, 2020, 55(7): 975-981.

QIAN Duo, WANG Meiling, JIANG Bingxin, ZHAO Dan. Application of early lower limb rehabilitation activities in patients with lower extremity deep venous thrombosis after catheter-directed thrombolysis[J]. Chinese Journal of Nursing, 2020, 55(7): 975-981.

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