CAJ | 학술논문

目的：探讨集束干预策略对预防重症缺血性脑卒中患者下肢深静脉血栓（DVT）的影响。方法选择2012年神经内科重症监护病房收治的228例重症缺血性脑卒中患者作为集束干预组，实施集束干预策略，采用包括预防性筛查、体位护理、营养支持和液体管理、保护血管、物理预防、药物预防、被动运动等措施；选择2011年重症监护病房重症缺血性脑卒中患者206例作为对照组，采用常规护理。比较两组患者下肢DVT的发生情况。结果集束干预组仅8例出现下肢DVT，发生率为3.51％，对照组出现49例，发生率为23.79％，两组比较，差异有统计学意义（χ2＝39.0041，P＜0.01），但是单、双侧肢体瘫痪发生率比较，差异无统计学意义（χ2＝0.1529，P＝0.696）。结论集束干预策略可有效降低重症缺血性脑卒中患者下肢DVT的发生率，值得临床推广使用。
목적：탐토집속간예책략대예방중증결혈성뇌졸중환자하지심정맥혈전（DVT）적영향。방법선택2012년신경내과중증감호병방수치적228례중증결혈성뇌졸중환자작위집속간예조，실시집속간예책략，채용포괄예방성사사、체위호리、영양지지화액체관리、보호혈관、물리예방、약물예방、피동운동등조시；선택2011년중증감호병방중증결혈성뇌졸중환자206례작위대조조，채용상규호리。비교량조환자하지DVT적발생정황。결과집속간예조부8례출현하지DVT，발생솔위3.51％，대조조출현49례，발생솔위23.79％，량조비교，차이유통계학의의（χ2＝39.0041，P＜0.01），단시단、쌍측지체탄탄발생솔비교，차이무통계학의의（χ2＝0.1529，P＝0.696）。결론집속간예책략가유효강저중증결혈성뇌졸중환자하지DVT적발생솔，치득림상추엄사용。
Objective To investigate the effect of bundle of care in the prevention of lower extremities deep venous thrombosis ( DVT) among patients with severe ischemic stroke .Methods Two hundred and twenty-eight patients with severe ischemic stroke in the Neurological Intensive Care Unit (NICU) in 2012 were selected as experimental group , and 206 patients with severe acute ischemic stroke in NICU in 2011 as control group.In the experimental group, the patients were treated with bundle of care , which included preventive screening, body position nursing care, nutrition support and liquid management , vascular protection, physical prevention, medicine prevention, passive movement and other measures .And in control group, conventional nursing was applied.The incidence of DVT was observed and compared in two groups .Results There were only 8 patients (3.51%) with lower extremities DVT in the experimental group , and 49 patients (23.79%) with lower extremities DVT in the control group , the difference was statistically significant between the two groups (χ2 =39.004 1,P <0.01).However, there was no statistically significant difference in the incidence of unilateral and bilateral limbs paralysis (χ2 =0.152 9,P=0.696).Conclusions The application of bundle of care can effectively reduce the incidence of deep venous thrombus of lower extremity in patients with severe ischemia stroke.It is worth for clinical use.