| Deep vein thrombosis(DVT)often occur after surgical operations, and it is probably followed by pulmonary embolism associated with an increased risk of death. With the development of new technology, new diagnosis and care schemes of neurosurgery, there has been a rapid in surgery numbers and postoperative DVT is getting more and more attention. Studies of postoperative DVT is popular at abroad, where has formed some large prospective studies.However, studies on clinical symptoms and related risk factors of DVT are fewer at home, especially those in depth retrospective studies of targeted. In the first part we adopted a case-control study to analyze the risk factors and clinical characteristics of DVT in neurosurgical people. In part two a questionnaire survey was carried out in nurses about the cognition degree of DVT. The questionnaire survey was based on the outcome of the part one’s study and aimed to guide nursing practice, management and education.Objective:1. To analyze risk factors of DVT in neurosurgical patients and provide theory basis for the prevention and nursing practice of DVT.2. To investigate the cognition degree in nurses on DVT and provide theory basis for nursing practice, management and education.Methods: PartⅠ: A total of 68 cases of neurosurgical patients with DVT in three general hospitals from August 2010 to August 2013 were collected. The design method of one to one matching case-control study was used controlling age, sex and neurosurgical disease. The information about general data, feature of disease, treatment methods, biochemical testing data and clinical symptoms of thrombosis were collected from medical records. We use SPSS18.0 as statistical analysis. Every risk factor was analyzed by single factor correlation analysis and multi-factor regression analysis to study risk factors of DVT.PartⅡ: The second part was a questionnaire survey referred to the research results of the first part and on the basis of literature review. This study was to investigate the cognition degree of nurses on DVT and to compare knowledge scores in nurses of different characteristics.Results: 1. Mono-factor analysis showed that: Coma, paralysis and limb immobilization, infection, trauma and fracture, lower limbs central venous catheterization, trachea cannula or tracheotomy, mechanical ventilation, surgical operation, operation time, blood transfusions, dehydration, vascular active drugs, elevated blood sugar, c-reactive protein, fibrinogen, D-Dimer in the differences between the two groups had statistical significance. Deep vein thrombosis was regarded as the dependent variable and the above 16 factors as the independent variable when we performed conditional logistic regression analysis. Coma, paralysis and limb immobilization, infection, lower limb central venous catheterization may be risk factors for DVT in neurosurgical patients.2. The characteristic of thrombosis in sixty-eight neurosurgical patients with DVT was described as follows: Thrombosis occurred in the lower extremities, mainly in the right lower limb and the majority type was mix type. The prognosis in neurosurgical patients of DVT was poor; the common primary diseases of these patients were cerebral hemisphere lesion diseases and brain stem diseases.3. The scores of DVT knowledge in neurosurgical nurses were lower. The knowledge scores in nurses of different age, working history showed no significant differences(P>0.05). The knowledge scores in nurses of different educational background, professional titles and executive position were statistically significant(P<0.05). Nurses mostly held positive attitude on DVT. The frequent behavioral intervention on DVT was between 4.1% and 44.6%.Conclusion: 1. Coma, paralysis and limb immobilization, infection, lower limb central venous catheterization may be risk factors for DVT in neurosurgery. We should pay attention to patients with high risks of deep vein thrombosis and take preventive measures early to reduce the risks.2. The scores of DVT knowledge in neurosurgical nurses were lower, especially the nurses with low degree, low title and no executive position. It is imperative to strengthen the nursing training. Nurses held positive attitude on DVT and conduct behavior less. |
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