Abstract:

Objective To explore the effects of a nursing bundle for prevention of deep venous thrombosis（DVT） in lower extremities caused by blood purification in children patients.Methods A total of 315 patients in pediatric intensive care unit undergoing blood purification from a tertiary hospital in Changchun in 2017 were recruited as the experimental group,and received a nursing bundle,including assessment and screening,vascular protection,leg circumference assessment,nutritional support,body fluid management,body temperature management,body movement,position management,and other nursing measures;a total of 202 patients undergoing blood purification in 2016 were selected as the control group and received routine nursing. The occurrence of DVT in lower extremities was compared between two groups.Results In the experimental group,there were 40 cases（12.7%） of lower extremity DVT,including 36 cases（16.5%） in children aged 0~6 years,and 4 cases（4.12%） aged 7~14 years old. Twenty-two cases（11.3%） occurred in children whose treatment time was longer than 24 hours,and 18 cases（15%） whose treatment time was less than 24 hours. In the control group,there were 49 cases（24.3%）,including 39 cases（30.7%） in children aged 0~6 years old and 10 cases（13.3%）aged 7~14 years old. Twenty-five cases（22.5%） occurred in children whose treatment time was greater than 24 hours,and 24 cases（26.4%） of children whose treatment time was less than 24 hours. The difference in occurrence of DVT between two groups was statistically significant（ χ²=11.539,P<0.05）.Conclusion The nursing bundle can effectively reduce the incidence of DVT in lower extremities in children undergoing blood purification,especially for children older than 7 years old and whose treatment time is longer than 24 hours.

Key words: Nursing Bundle, Blood Purification, Pediatric Nursing, Deep Venous Thrombosis of Lower Extremity

摘要：

目的 探讨集束化护理对预防血液净化患儿下肢深静脉血栓形成的效果。方法 选择2017年长春市某三级甲等医院小儿重症监护病房收治的315例需要进行血液净化治疗的患儿作为实验组,实施集束化护理干预措施,护理措施包括评估筛查、血管保护、评估腿围、营养支持、体液管理、体温管理、肢体运动、体位管理等;选择2016年该小儿重症监护病房行血液净化治疗的患儿202例作为对照组,采用常规护理措施。比较两组下肢静脉血栓形成的发生情况。 结果 实验组40例（12.7%）发生下肢深静脉血栓,其中0~6岁36例（16.5%）,7~14岁4例（4.12%）;治疗时间≥24 h 22例（11.3%）,治疗<24 h 18例（15%）。对照组49例（24.3%）发生下肢深静脉血栓,其中0~6岁39例（30.7%）,7~14岁10例（13.3%）;治疗时间≥24 h 25例（22.5%）,治疗<24 h 24例（26.4%）。两组血栓发生情况比较,差异均有统计学意义（P<0.05）。结论 集束化护理干预可有效降低血液净化治疗患儿下肢深静脉血栓形成的发生率,尤其对年龄>7岁,上机时长≥24 h的患儿效果更佳。

关键词: 集束化护理, 血液净化, 儿科护理学, 下肢深静脉血栓