本文關(guān)鍵詞： VTE防控體系 骨科大手術(shù) 圍手術(shù)期 風(fēng)險(xiǎn)評(píng)估 臨床干預(yù)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:本文選取目前常用的風(fēng)險(xiǎn)評(píng)估模型進(jìn)行臨床應(yīng)用,通過(guò)對(duì)骨科手術(shù)患者進(jìn)行圍手術(shù)期VTE風(fēng)險(xiǎn)評(píng)估,以及臨床干預(yù),并對(duì)干預(yù)效果進(jìn)行觀察,對(duì)于今后如何降低VTE在骨科大手術(shù)患者中的發(fā)病提供參考意見(jiàn)。方法:應(yīng)用非隨機(jī)非同期對(duì)照試驗(yàn)法,選取廣西醫(yī)科大學(xué)第一附屬醫(yī)院自2011年1月至2013年6月在未實(shí)行VTE風(fēng)險(xiǎn)評(píng)估與干預(yù)時(shí)收治的并具有完整記錄的骨科大手術(shù)患者共計(jì)368例作為參照組;自2013年7月至2016年1月在已實(shí)行VTE風(fēng)險(xiǎn)評(píng)估與臨床干預(yù)后收治的并具有完整記錄的骨科大手術(shù)患者共413例作為干預(yù)組。參照“中國(guó)骨科大手術(shù)靜脈血栓栓塞癥預(yù)防指南[1]”中的caprini評(píng)分回顧評(píng)估參照組及干預(yù)組患者的圍手術(shù)期靜脈血栓栓塞危險(xiǎn)分度。將患者圍手術(shù)期是否發(fā)生DVT和PTE作為觀察指標(biāo)。根據(jù)病例及回訪綜合對(duì)比分析。結(jié)果:干預(yù)組有1例肺栓塞發(fā)生,未干預(yù)組有10例肺栓塞發(fā)生,未干預(yù)組VTE的發(fā)生率明顯高于干預(yù)組VTE的發(fā)生率。兩組之間相比較VTE總發(fā)生率具有差異,有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組組內(nèi)對(duì)比圍手術(shù)期VTE風(fēng)險(xiǎn)評(píng)估,危險(xiǎn)程度越高,其VTE的發(fā)生率就越高(P0.05)。結(jié)論:圍手術(shù)期VTE風(fēng)險(xiǎn)評(píng)估后危險(xiǎn)程度越高的患者,其VTE的發(fā)生率就越高;圍手術(shù)期對(duì)骨科手術(shù)患者進(jìn)行VTE風(fēng)險(xiǎn)評(píng)估并進(jìn)行臨床干預(yù),可極大的減少患者罹患VTE的風(fēng)險(xiǎn)。
[Abstract]:Objective: this article selects the current commonly used risk assessment model for clinical application, through the perioperative VTE risk assessment of orthopaedic patients, as well as clinical intervention, and observe the effect of intervention. For how to reduce the incidence of VTE in orthopedic patients in the future. Methods: a non-randomized, non-synchronous controlled trial was used. From January 2011 to June 2013, the first affiliated Hospital of Guangxi Medical University was selected from the first affiliated Hospital of Guangxi Medical University to treat 368 patients with complete records of major orthopaedic surgery without VTE risk assessment and intervention. As a reference group; From July 2013 to January 2016, a total of 413 cases of orthopedic major orthopedic surgery patients treated after VTE risk assessment and clinical intervention were treated as the intervention group. Guidelines for the Prevention of Venous Thrombosis in Major Orthopaedic surgery in China. [1] " The perioperative risk of venous thromboembolism (VTE) in the reference group and the intervention group was evaluated retrospectively. Whether DVT and PTE occurred during the perioperative period was used as the index. Comprehensive comparative analysis of return visits. Results:. Pulmonary embolism occurred in 1 case in the intervention group. There were 10 cases of pulmonary embolism in the non-intervention group, and the incidence of VTE in the non-intervention group was significantly higher than that of the VTE in the intervention group, and there was a difference in the total incidence of VTE between the two groups. Compared with perioperative VTE risk assessment, the higher the risk level of the two groups. Conclusion: the higher the risk level of perioperative VTE risk assessment, the higher the incidence of VTE. Perioperative VTE risk assessment and clinical intervention in orthopedic patients can greatly reduce the risk of VTE.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3

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