Application of evidence-based nursing program for prevention of venous thromboembolism in perioperativeperiod of hip and knee replacement
静脉血栓栓塞症预防循证护理方案在髋膝关节置换围手术期的应用

摘要

目的 针对循证护理方案在髋膝关节置换围手术期静脉血栓栓塞症预防中的价值展开分析。方法 选 取 2021 年 1 月-2022 年 1 月期间在我院接受髋膝关节置换术的 116 例患者作为研究对象，采用抛币法分为对照组 和研究组，各 58 例，对照组给予常规护理，研究组采用循证护理方案，比较两组患者护理前后焦虑自评量表（SAS）、 抑郁自评量表（SDS）评分及静脉血栓与并发症的发生率、髋膝关节活动度。结果 护理前，两组患者 SAS、SDS 评分对比无明显差异（P＞0.05）；护理后，研究组 SAS、SDS 评分均低于对照组（P＜0.05）；研究组静脉血栓、 假体松动、切口感染、关节内感染、患肢疼痛发生率低于对照组（P＜0.05）；研究组髋关节活动度与膝关节活动 度均优于对照组（P＜0.05）。结论 在髋膝关节置换围手术期实施循证护理方案，能够有效预防静脉血栓栓塞症 及并发症的发生，同时消除负性情绪对患者的影响,对促进患者关节功能恢复有重要价值，值得推广。

Abstract

Objective To analyze the value of evidence-based nursing in the prevention of venous thromboembolism during perioperative period of hip and knee replacement.
Methods 116 patients who received hip and knee arthroplasty in our hospital from January 2021 to January 2022 were selected as the research objects. They were divided into a control group and a study group by coin toss method, with 58 cases in each group. The control group was given routine nursing care. The study group was given evidence-based nursing care. The scores of Self Rating Anxiety Scale (SAS), Self Rating Depression Scale (SDS), the incidence of venous thrombosis and complications, and the activity of hip and knee joints were compared between the two groups before and after nursing. Result Before nursing, there was no significant difference in SAS and SDS scores between the two groups of patients (P>0.05); After nursing, the SAS and SDS scores of the study group were lower than those of the control group (P<0.05); The incidence of venous thrombosis, prosthesis loosening, incision infection, intra-articular infection and limb pain in the study group was lower than that in the control group (P<0.05); The range of motion of the hip and knee joints in the research group was better than that in the control group (P<0.05).
Conclusion   The implementation of evidence-based nursing program in the perioperative period of hip and knee replacement can effectively prevent the occurrence of venous thromboembolism and complications, and eliminate the impact of negative emotions on patients, which has important value in promoting the recovery of patients' joint function and is worth promoting.