| ObjectiveInvestigate the efficacy of evidence-based cluster nursing in the prevention of deep venous thrombosis(DVT)after hip arthroplasty.To provide a scientific and effective way to enrich the clinical nurses' care of hip arthroplasty patients.This study is an important application of evidence-based medicine in the field of nursing,it establishes standard clinical nursing mode,which guides nursing staff to improve the quality of nursing service and improve the satisfaction of patients.Methods90 cases of hip arthroplasty were divided into control group(45 cases)and intervention group(45 cases)according to baseline data.The control group was given general prevention of DVT,and the intervention group was given evidence-based cluster nursing,and then observe the clinical efficacy of the two groups of nursing.Observe the incidence of venous thrombosis,Homan sign and Neuhof sign within 9 days before and after operation;Measure limb surface temperature of 5cm above the ankle,10 cm below patella,15 cm above patella about two groups;Measure limb circumference of 5cm above the ankle and 15 cm above the patella about two groups;Blood tests were performed to detect levels of D-dimer and homocysteine(Hcy)on days 1,4,and 7 before and after operation;Color Doppler examination was performed to measure the peak flow velocity and mean flow velocity of femoral vein on days 1 and 7 before and after operation.Processing data with SPSS16.0 statistical package,expressing measurement data by mean ±standard deviation(sx ±);The data between the two groups were normal distribution and homogeneous variance,and the mean between the two groups was compared by t test;Enumeration data were compared by Pearson chi square test or corrected chi square test,the difference of P<0.05,was statistically significant.Results1.There were 0 cases of thrombus in the intervention group and 6 cases in the control group,and the intervention group was significantly less than that of the control group(P<0.05).The incidence of Homan sign(+)in the intervention group was 28.89%,and the incidence rate of Neuhof sign(+)was 22.22%,which was statistically significant compared with that of the control group.(X2 =4.630,P<0.05;X2 =5.954,P<0.05).2.Comparison of body surface temperature between two groups of 5cm above the ankle,10 cm blow the patellar,15 cm above the patella.There was no statistical significance about comparison difference of the body surface temperature between two groups of 5cm above the ankle,10 cm blow the patellar,15 cm above the patella(P>0.05).The limb surface temperature of 5cm above the ankle about intervention group in 2-4 days after operation was significantly lower than the control group(P<0.05),The limb surface temperature of 10 cm blow the patellar,15 cm above the patella about intervention group in 1-4 days after operation was significantly lower than the control group(P<0.05).3.Comparison of 5cm above the ankle and 15 cm above patella limb circumference about two groups.There was no statistical significance about comparison difference of the limb circumference between two groups of 5cm above the ankle,15 cm above the patella before surgery(P>0.05);There was no statistical significance about comparison difference of the limb circumference between two groups of 5cm above the ankle after surgery(P>0.05).The limb circumference of 15 cm above the patella in the two groups increased in the 3-5 days after operation,and the intervention group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).4.Comparison of plasma DD and Hcy levels between the two groups.There was no statistical significance about comparison difference of DD and Hcy levels in the two groups before operation(P>0.05);After first days,the two groups of DD and Hcy levels were elevated,the difference between the two groups were not statistically significant(P>0.05);Fourth days after operation,the two groups of DD and Hcy levels were elevated,the difference between the two groups were statistically significant(P<0.05).5.Comparison of peak flow velocity and mean velocity of two groups femoral vein color Doppler ultrasound.The difference between the two groups was not statistically significant before surgery(P>0.05);Seventh days after operation,the two groups were significantly higher than the preoperative,and the intervention group increased more obviously,the difference between the two groups was statistically significant(P<0.05).ConclusionEvidence based cluster nursing interventions can effectively prevent and reduce the incidence of deep vein thrombosis in patients undergoinghip arthroplasty,and improve the clinical curative effect.which has important clinical application value. |
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