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| Effectiveness of risk-based care thinking in preventing lower extremity venous thrombosis in patients undergoing continuous hemodialysis |
| MA Qing XU Xianrong▲ XU Jing CHEN Lvjing YE Yajun WU Buyun MAO Huijuan |
| Severe Renal Disease Area, Jiangsu Provincial People’s Hospital, Jiangsu Province, Nanjing 210000, China |
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Abstract Objective To investigate the effectiveness of risk-based care thinking in preventing lower extremity venous thrombosis in patients undergoing continuous hemodialysis. Methods Ninety-two patients who received continuous hemodialysis treatment in the Renal Disease Intensive Care Unit of Jiangsu Provincial People’s Hospital from October 2018 to September 2021 were selected for the study. The envelope method was used to divide the patients into control group and observation group, with 41 cases in each group. Both groups implemented conventional nursing interventions, while the observation group implemented risk-based nursing thinking on this basis. Before and a week after the intervention, venous blood flow velocity, lower extremity swelling, and incidence of lower extremity venous thrombosis were observed and compared. Results After a week of intervention, the whole blood viscosity low cut, whole blood viscosity medium cut, whole blood viscosity high cut, and plasma viscosity in both groups were lower than before the intervention, while those of the observation group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). After a week of intervention, the blood flow velocity in femoral and popliteal veins in both groups were higher than before the intervention, while those of the observation group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). The incidence of limb swelling and deep vein thrombosis in the observation group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion Implementing risk-based care thinking for continuous hemodialysis patients accelerates lower extremity venous blood flow and prevents lower extremity venous thrombosis and limb swelling.
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[1] 李凡，徐金艳，荆璐，等.连续性血液净化患者护理质量评价指标体系的构建[J].护理实践与研究，2021，18（6）：945-948.
[2] Sanjeet B，Marion M，Vincent B，et al. Continuous Veno- Venous High Cut-Off Hemodialysis Compared to Continuous Veno-Venous Hemodiafiltration in Intensive Care Unit Acute Kidney Injury Patients [J]. Blood Purification，2018， 46（3）：248-256.
[3] 李亚红，蒋文慧，李荣，等.血液净化患儿下肢深静脉血栓的形成因素及预防研究[J].护理管理杂志，2021，21（8）：594-597，602.
[4] 张俊丽，蔡卫新，梁建姝，等.Caprini风险评估模型预测不同科室住院患者深静脉血栓形成的价值研究[J].护士进修杂志，2019，34（4）：359-362.
[5] Song YH，Seo EH，Yoo YS，et al. Phosphate supplementation for hypophosphatemia during continuous renal replacement therapy in adults [J]. Renal Failure，2019，41（1）：72-79.
[6] Hendrix RJ，Hastings MC，Samarin M，et al. Predictors of Hypophosphatemia and Outcomes during Continuous Renal Replacement Therapy [J]. Blood Purification，2020，49（6）：1-8.
[7] Ronco C，Bagshaw SM，Bellomo R，et al. Extracorporeal Blood Purification and Organ Support in the Critically Ill Patient during COVID-19 Pandemic：Expert Review and Recommendation [J]. Blood Purif，2021，50（1）：17-27.
[8] 王瑞敏，苗金红，岳晓红.基于Donabedian质量理论的护理干预在心血管通路术的血液净化患者中的应用效果分析[J].中华现代护理杂志，2020，26（36）：5090-5094.
[9] 刘莲琴，缑楠，党羽.股静脉留置透析导管患者深静脉血栓形成的危险因素及对策[J].血栓与止血学，2020，26（5）：843-845.
[10] Sheng C，Yang C，Jing Z，et al. The Use of Continuous Blood Purification for the Treatment of Malignant Hyperthermia in an Infant [J]. J Cardiothorac Vasc Anesth，2021，35（11）：3307-3310.
[11] 董苗苗，林晓敏，林凌洁，等.基于连续性血液净化风险控制的治疗性护理程序在PICU严重脓毒症患儿中的构建及应用[J].中国中西医结合急救杂志，2020，27（6）：705-708.
[12] 成晓晴.中心静脉导管与深静脉血栓形成的关系研究[J].临床急诊杂志，2019，20（12）：989-992.
[13] 吴函书，张葆荣，刘洋，等.集束化护理预防血液净化患儿下肢深静脉血栓形成的效果研究[J].中华护理杂志，2019，54（3）：368-373.
[14] Ni J，Fang K，Zhao Z，et al. Continuous Blood purification on Influenza-Associated Neurological Disease in children：a retrospective cohort study [J]. BMC Infect Dis，2021，21（1）：673.
[15] 周红艳，郭彩利，闫林平，等.PDCA循环联合静脉通路管理预防下肢静脉血栓的效果研究[J].河北医药，2021， 43（3）：474-476，480.
[16] 刘伟俊，吴锡信，江峡.蛋白结合尿毒症毒素与血液净化的研究现状[J].现代医院，2020，20（7）：1053-1057.
[17] 张仲华，曾铁英，徐蓉，等.无抗凝连续性血液净化治疗体外循环装置堵塞危险因素分析[J].中华现代护理杂志，2019，25（34）：4405-4411.
[18] Wang R，Lin L，Zhu Q，et al. Nursing effect of continuous blood purification therapy in treatment of severe sepsis [J]. Am J Transl Res，2021，13（9）：10801-10808.
[19] 邓真真，陈铖.不同血液净化模式对患者冠状动脉钙化及血清COMP、FGF-23表达的影响[J].中国医学创新，2021，18（4）：85-89.
[20] 王莉.连续性血液净化中患者相关凝血风险及护理预防措施[J].血栓与止血学，2017，23（1）：140-142.
[21] 赵云峰，徐志华，顾维立.连续性血液净化治疗脓毒症合并急性肾损伤患者效果及对免疫和炎症因子影响[J].中国急救复苏与灾害医学杂志，2021，16（8）：895-898.
[22] 赵春莉，董志扬，曹昌萌，等.血液净化对急性心力衰竭合并周身浮肿患者心功能的影响[J].中国医药导报，2021， 18（29）：73-76，85.
[23] 韩金涛，杨莉，祁晓芳，等.急性中毒患者血液净化治疗中下肢静脉血栓的预防及护理[J].河北医药，2020，42（16）：2549-2553.
[24] 袁静，李恒，应金萍，等.102例血液透析患者动静脉内瘘血栓形成的原因及护理[J].中华护理杂志，2020，55（4）：607-610.
[25] 陈日喜.质量控制在血液净化护理质量管理中的应用[J].中国医药科学，2021，11（9）：201-204.
[26] 王婷，李玉芳，尼加提·阿布都热合曼，等.血液透析患者血清可溶性晚期糖基化终末产物受体、内源性分泌型晚期糖基化终末产物受体水平与动静脉内瘘血栓形成的关系[J].中国医学前沿杂志（电子版），2021，13（10）：94-98.
[27] 魏华，王佳丽，杨玉霞.老年维持性血液透析患者血清鸢尾素水平与动静脉内瘘血栓形成的相关性[J].中国老年学杂志，2019，39（22）：5553-5556.
[28] 李艳慧，邱模炎，栾洁，等.改良透析浓缩液桶盖对透析液感控指标影响的研究[J].北京生物医学工程，2020， 39（5）：518-522.
[29] Drummond M，Federici C，Busink E，et al. Performance- based risk-sharing agreements in renal care：current experience and future prospects [J]. Expert Rev Pharmacoecon Outcomes Res，2021，21（2）：197-209.
[30] 中国医院协会血液净化中心管理分会血液净化通路学组.中国血液透析用血管通路专家共识（第1版）[J].中国血液净化，2014，13（8）：549-558. |
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