Study On The Prevention Of Deep Venous Thrombosis In Patients With Acute Ischemic Stroke By Cluster Nursing

Objective To construct a bundled nursing intervention program for deep venous thrombosis of acute ischemic stroke and implement and verify the clinical feasibility,practicability and effectiveness of the bundled nursing intervention program for prevention of deep venous thrombosis of patients with acute ischemic stroke.To clarify the preventive effect of bundled nursing intervention programs on lower limb deep vein thrombosis in patients with acute ischemic stroke,to provide practical and feasible nursing programs for the clinic,reduce their incidence and improve the quality of clinical nursing.Methods Based on the evidence-based medicine methodology,construct a clustered nursing intervention plan to prevent deep vein thrombosis after acute ischemic stroke;establish an evidence-based nursing practice group under the guidance of the mentor group,with the head nurse as the evidence-based nursing practice group The team leader regularly trains neurologists on evidence-based nursing knowledge and monitors the quality of the neuronursing nurses' implementation of clustered nursing interventions.60 cases of acute ischemia from the Department of Neurology,Yanan Hospital of Kunming City,in line with the diagnostic criteria of the "Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke" revised by the Chinese Medical Association in 2014,and confirmed by the NIHSS score table and head CT / MRI Stroke patients were divided into test group and control group by random number table method,30 cases in each group;the control group adopted routine nursing program,and the test group adopted cluster nursing intervention program.After 10 days of intervention,the patient's lower limb color Doppler examination,blood fibrinolysis index,coagulation index and clinical symptoms were used as the detection indicators of deep vein thrombosis,combined with the clinical observation scale to comprehensively judge whether the patient had deep vein thrombosis.The results of the examination and the data obtained were statistically analyzed using SPSS22.0 software to clarify the effect of cluster nursing interventions in the prevention of deep venous thrombosis in patients with acute ischemic stroke.Result 1.Constructed a bundled nursing intervention plan for preventing lower limb deep vein thrombosis of acute ischemic stroke,which includes 6 items: risk screening,early activities,basic nursing,mechanical prevention,hydration and fluid replacement,and health education.2.The general data results of the two groups of patients on the first day of admission were not statistically different(P> 0.05).3.The NIHSS scores of the two groups before the intervention were not statistically different(P> 0.05).After the intervention,the NIHSS scores of the experimental group were lower than those of the control group,and the difference was statistically significant(P <0.05).4.The padua score of the two groups before the intervention was not statistically different(P> 0.05).After the intervention,the Padua score of the test group was lower than that of the control group,and the difference was statistically significant(P <0.05).5.The BI score and mRS score of the two groups before the intervention were not statistically different(P> 0.05).After the intervention,the BI score and mRS score of the experimental group were better than the control group,and the difference was statistically significant(P <0.05).6.There was no statistically significant difference in the coagulation indexes(thrombin time,prothrombin time,activated partial thromboplastin time,fibrinogen time)between the two groups before the intervention(P> 0.05).Outer than the control group,the difference was statistically significant(P <0.05).7.The fibrinolysis index(D-dimer measurement)of the two groups before the intervention was not statistically different(P> 0.05).After the intervention,the D-2 polymer in the test group was lower than the control group,and the difference was statistically significant(P < 0.05).8.Before the intervention,the two groups underwent physical examination.There was no statistically significant difference in clinical symptoms related to the number of affected legs and swelling of the affected legs(P> 0.05).After the intervention,1 patient in the control group developed swelling,affected legs,and There was no statistically significant difference between the two groups in the swelling of the affected limb(P> 0.05).9.There was no statistically significant difference in lower limb muscle strength scores between the two groups before intervention(P> 0.05).After the intervention,the muscle strength of the test group was better than that of the control group,and the difference was statistically significant(P <0.05).10.After the intervention,the two groups underwent color Doppler ultrasound screening of the lower extremity blood vessels.In the control group,4 cases developed blood stasis and 1 case developed deep vein thrombosis.Statistical significance(P <0.05).Conclusion 1.The clustered nursing intervention program provides certain evidence-based evidence and process reference for clinical nursing practice,and provides scientific,economical and effective nursing services for the prevention of deep venous thrombosis of patients with acute ischemic stroke Improve the quality of nursing management,thereby improving the clinical outcome of patients,saving medical and health costs,and promoting scientific evidence-based nursing practice.2.The clustered nursing intervention program reduces the risk of deep venous thrombosis in patients with acute ischemic stroke,improves the patient's coagulation function and muscle strength,and promotes the recovery of patients' lower limb function.It is worthy of clinical promotion.3.For patients with acute ischemic stroke,the Padua risk scale can be used to pre-warn the risk of secondary deep vein thrombosis in the lower extremities,and is worthy of clinical application.4.In the practice of evidence-based nursing,by enhancing the evidence-based awareness of clinical nursing staff,strengthening the health education of patients,promoting knowledge conversion,multi-disciplinary cooperation,the research results are translated into practical actions,and the quality of nursing management is improved.