全关节置换术后下肢深静脉血栓形成影响因素分析及护理对策OA

Objective To investigate the influencing factors and nursing countermeasures of lower extremity deep venous thrombosis(DVT)after total joint replacement.Methods The convenience sampling method was used to select patients who underwent total joint replacement in the Second Affiliated Hospital of Chongqing Medical University from October 2022 to December 2023 as the study subjects.According to whether DVT occurred within 30 days after operation,they were divided into DVT group and non-DVT group.Generalized linear mixed model was used to analyze the influencing factors of DVT.Results A total of 106 patients were enrolled,including 30 patients in the DVT group,accounting for 28.3%,and 76 patients in the non-DVT group,accounting for 71.7%.Generalized linear mixed model analysis showed that age(OR=1.110,95%CI(1.030-1.198),P=0.007),Charlson score(OR=1.650,95%CI(1.140-2.390),P=0.009),postoperative bed rest time(d)(OR=1.161,95%CI(1.016-1.393),P=0.040),postoperative pharmacologic prophylaxis initiation time(h)(OR=1.012,95%CI(1.003-1.021),P=0.046),and postoperative mechanical prophylaxis initiation time(h)(OR=1.027,95%CI(1.005-1.056),P=0.037)are factors influencing lower extremity deep vein thrombosis after total joint replacement.Conclusions Clinical medical staff should pay attention to the prevention and treatment of DVT in elderly patients and patients with multiple diseases,start mechanical prophylaxis and drug prevention as soon as possible,pay attention to the postoperative activity ability of patients,encourage and guide patients to get out of bed early,and flexibly formulate personalized prevention and treatment programs to avoid the occurrence of DVT,so as to improve the prognosis.