摘要
目的系统评价ICU患者静脉血栓栓塞症（VTE）的护理预防措施及应用效果。方法检索PubMed、Cochrane Library、EMBASE、SCI、CINAHL、Science Direct、CBM、CNKI、万方、维普数据库，收集国内外与ICU患者VTE护理预防相关的随机对照试验（RCT）。结果共纳入57篇RCT，Meta分析结果示，应用间歇充气加压治疗（IPC）和皮下注射低分子肝素对重症外伤患者VTE的预防效果及出血并发症发生率比较差异无统计学意义（P=0．14）；IPC与医用弹力袜（GCS）联合使用后深静脉血栓（DVT）发生率低于GCS单独使用组（P=0．003）；IPC组VTE发生率低于常规护理组（P〈0．01），下肢静脉血流速度和静脉血流峰平均速度均大于常规护理组（P〈0．01）；应用GCS后VTE发病率低于常规组（P〈0．01）。描述性分析结果显示，早期综合护理干预，采取VTE风险评估后给予针对性护理干预可降低ICU患者DVT发生率。结论综合现有方案，应用IPC、应用GCS、早期综合护理干预、采取DVT风险评估后给予针对性护理干预是预防ICU患者VTE的有效措施。
Objective To systematically review the nursing preventive interventions and their effects on venous thromboembolism （VTE） in ICU patients. Methods We searched PubMed, Cochrane Library, EMBASE, SCI, CINAHL, Science Direct, BM, CNKI, WanFang and VIP, to collect the randomized controlled trials of nursing prophylaxis on VTE in ICU patients. Results 57 studies were included, meta-analysis provided that： the incidence rates of VTE and bleeding between Intermittent Pneumatic Compression Devices（IPC） group and low molecular weightheparin group in severe trauma patients had no statistical significance （P=0.14）; comparing with graduated compression stockings （GCS） only group, the incidence rates of deep vein thrombosis（DVT） were lower in combination with IPC and GCS group （P=0.003）; comparing with routine nursing group, the incidence rates of VTE were lower in IPC group and GCS group （P〈0.01）, the blood flow velocity and the average velocity of venous flow in lower limbs were increased in IPC group （P〈0.01）. The results of descriptive analysis show that early comprehensive nursing interventions and corresponding nursing interventions after risk assessment can reduce the incidence of VTE in ICU. Conclusion According to the present projects, using IPC, GCS, adopting early comprehensive nursing interventions and giving corresponding nursing interventions after DVT risk assessment are the effective interventions on ICU VTE.
作者
张晶晶
江智霞
张霞
杨凯涵
潘燕彬
权明桃
陈芳
曾慧
Zhang Jingjing Jiang Zhixia Zhang Xia Yang Kaihan Pan Yanbin Quan Mingtao Chen Fang Zeng Hui(Nursing Department, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, Chin)
出处
《中国实用护理杂志》
2017年第26期2069-2073,共5页
Chinese Journal of Practical Nursing
关键词
重症监护病房
静脉血栓栓塞
护理
预防
Intensive care units
Venous thromboembolism
Nursing care
Prevention
