付春玲, 刘红英, 郭英, 史立坡, 傅义程. 基于静脉血栓栓塞症风险评分的综合措施干预高龄2型糖尿病住院患者静脉血栓的发生[J]. 上海预防医学, 2023, 35(4): 320-325. DOI: 10.19428/j.cnki.sjpm.2023.22539
引用本文: 付春玲, 刘红英, 郭英, 史立坡, 傅义程. 基于静脉血栓栓塞症风险评分的综合措施干预高龄2型糖尿病住院患者静脉血栓的发生[J]. 上海预防医学, 2023, 35(4): 320-325. DOI: 10.19428/j.cnki.sjpm.2023.22539
FU Chunling, LIU Hongying, GUO Ying, SHI Lipo, FU Yicheng. Clinical value of comprehensive intervention based on VTE risk score for venous thrombosis in elderly type 2 diabetes inpatients[J]. Shanghai Journal of Preventive Medicine, 2023, 35(4): 320-325. DOI: 10.19428/j.cnki.sjpm.2023.22539
Citation: FU Chunling, LIU Hongying, GUO Ying, SHI Lipo, FU Yicheng. Clinical value of comprehensive intervention based on VTE risk score for venous thrombosis in elderly type 2 diabetes inpatients[J]. Shanghai Journal of Preventive Medicine, 2023, 35(4): 320-325. DOI: 10.19428/j.cnki.sjpm.2023.22539

基于静脉血栓栓塞症风险评分的综合措施干预高龄2型糖尿病住院患者静脉血栓的发生

Clinical value of comprehensive intervention based on VTE risk score for venous thrombosis in elderly type 2 diabetes inpatients

  • 摘要:
    目的 探究基于静脉血栓栓塞症(VTE)风险评分的针对性干预措施预防高龄2型糖尿病内科住院患者的应用效果,以及对VTE发生的影响。
    方法 以2018年6月1日—2019年9月30日北京大学第三医院老年内科的100例高龄2型糖尿病住院患者为研究对象所有患者按照随机数字表法分为对照组和观察组,每组50例患者。对照组患者采用常规干预方法,观察组患者则采用基于VTE风险评分的针对性干预措施。干预2周后,比较2组患者的Padua评分、血糖水平和凝血指标,记录和分析患者干预期间的血栓发生率。
    结果 观察组患者的Padua评分明显低于对照组患者(P<0.05),分别为(2.09±2.17)分和(3.19±2.37)分;观察组患者的空腹血糖、餐后2 h血糖水平明显低于对照组患者(P<0.05);观察组患者的纤维蛋白原、D⁃二聚体水平、活化部分凝血活酶时间和凝血酶原时间均明显低于对照组患者(P<0.05);观察组患者发生深静脉血栓、肺血栓栓塞症、下肢肿胀、疼痛、皮肤颜色异常比率分别为4.00%、2.00%、2.00%、2.00%、0.00%,对照组分别为12.00%、10.00%、10.00%、12.00%、8.00%,观察组患者的各项不良事件发生率明显低于对照组患者(P<0.05)。
    结论 对高龄2型糖尿病内科住院患者采用基于VTE风险评分的针对性干预能明显降低患者的VTE发生风险,改善凝血功能和血糖水平。该措施有重要临床应用价值。

     

    Abstract:
    Objective To explore the effect of targeted intervention measures based on risk score of venous thromboembolism (VTE), on the prevention of senile type 2 diabetes inpatients, as well as their influence on the occurrence of venous thromboembolism.
    Methods A total of 134 elderly patients with type 2 diabetes mellitus who were hospitalized in geriatrics department of Peking university third hospital during June 1, 2018 to September 30, 2018 were selected as the research subjects. All the patients were divided into control group and observation group according to random number table method, with 67 patients in each group. Patients in the control group were treated with conventional intervention methods, and patients in the observation group were treated with targeted intervention measures based on VTE risk score. After one month of intervention, the Padua score, blood glucose level and coagulation indexes of the two groups were compared. The incidence of thrombosis during the intervention period was also recorded.
    Results The Padua score in observation group (2.09±2.17) points was significantly lower than that (3.19±2.37) points in control group (P<0.05). The indexes of fasting blood glucose, 2h postprandial blood glucose and HbA1c in observation group were significantly lower than those in control group (P<0.05). The fibrinogen, D-dimer, activated partial thromboplastin time and prothrombin time in observation group were significantly lower than those in control group (P<0.05). The incidence of DVT, PVT, lower limb swelling, pain and abnormal skin color in the observation group were 4.00%, 2.00%, 2.00%, 2.00%, and 0, respectively, and in the control group were 12.00%, 10.00%, 10.00%, 12.00%, and 8.00%, respectively. The incidence of adverse events in observation group was significantly lower than that in control group (P<0.05).
    Conclusion Targeted intervention based on VTE risk score can significantly reduce the risk of VTE occurrence, improve blood clotting function and blood glucose level in elderly patients with type 2 diabetes mellitus. This nursing measure has important clinical application value.

     

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