{"title":"护理辅助预警干预预防剖宫产后静脉血栓栓塞的效果。","authors":"Bichao Wan, Dongying Fu, Shijiang Chen, Fuying Tao, Jianan Jiang, Yingying Tian","doi":"10.1097/FM9.0000000000000245","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism (VTE) and preventing VTE following cesarean delivery (CD).</p><p><strong>Methods: </strong>A prospective cohort study conducted between January 1, 2020, and December 30, 2022, enrolled pregnant women who underwent CD in the obstetric unit of Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital. The patients were assigned to a control group (routine nursing care) or the intervention group (nurse-assisted early warning intervention) depending on whether or not the nurse-assisted early warning intervention had been implemented. The <i>χ</i> <sup>2</sup> test and Student's <i>t</i>-test were used for statistical analysis. The primary outcome was the incidence of systemic VTE following CD, and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis.</p><p><strong>Results: </strong>A total of 27,074 cases were enrolled. The incidence of symptomatic VTE following CD was significantly lower in the intervention group (0.29 per 1000 deliveries) than in the control group (2.4 per 1000 deliveries) (<i>P</i> < 0.001). Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group (respectively, 19.8% <i>vs.</i> 12.6% receiving mechanical prophylaxis and 0.9% <i>vs</i>. 0.2% receiving pharmacological prophylaxis). No cases of life-threatening bleeding occurred in either group.</p><p><strong>Conclusion: </strong>The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"6 4","pages":"225-231"},"PeriodicalIF":1.7000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094333/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Nurse-Assisted Early Warning Intervention for Prevention of Venous Thromboembolism Following Cesarean Delivery.\",\"authors\":\"Bichao Wan, Dongying Fu, Shijiang Chen, Fuying Tao, Jianan Jiang, Yingying Tian\",\"doi\":\"10.1097/FM9.0000000000000245\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism (VTE) and preventing VTE following cesarean delivery (CD).</p><p><strong>Methods: </strong>A prospective cohort study conducted between January 1, 2020, and December 30, 2022, enrolled pregnant women who underwent CD in the obstetric unit of Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital. The patients were assigned to a control group (routine nursing care) or the intervention group (nurse-assisted early warning intervention) depending on whether or not the nurse-assisted early warning intervention had been implemented. The <i>χ</i> <sup>2</sup> test and Student's <i>t</i>-test were used for statistical analysis. The primary outcome was the incidence of systemic VTE following CD, and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis.</p><p><strong>Results: </strong>A total of 27,074 cases were enrolled. The incidence of symptomatic VTE following CD was significantly lower in the intervention group (0.29 per 1000 deliveries) than in the control group (2.4 per 1000 deliveries) (<i>P</i> < 0.001). Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group (respectively, 19.8% <i>vs.</i> 12.6% receiving mechanical prophylaxis and 0.9% <i>vs</i>. 0.2% receiving pharmacological prophylaxis). No cases of life-threatening bleeding occurred in either group.</p><p><strong>Conclusion: </strong>The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.</p>\",\"PeriodicalId\":74121,\"journal\":{\"name\":\"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)\",\"volume\":\"6 4\",\"pages\":\"225-231\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094333/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/FM9.0000000000000245\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/FM9.0000000000000245","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估护士辅助早期预警干预在改善预防产科静脉血栓栓塞（VTE）和预防剖宫产（CD）后静脉血栓栓塞（VTE）中的作用。方法：一项前瞻性队列研究于2020年1月1日至2022年12月30日在南京医科大学妇产医院、南京妇幼保健医院产科接受CD的孕妇进行。根据是否实施护士辅助预警干预，将患者分为对照组（常规护理）和干预组（护士辅助预警干预）。采用χ 2检验和学生t检验进行统计分析。主要结局是CD后全身性静脉血栓栓塞的发生率，次要结局是静脉血栓栓塞的机械或药物预防率以及药物预防相关不良事件的频率和严重程度。结果：共纳入27,074例。干预组CD后症状性静脉血栓栓塞的发生率（0.29 / 1000次分娩）显著低于对照组（2.4 / 1000次分娩）（P < 0.001）。干预组机械和药物预防静脉血栓栓塞的病例明显多于对照组（机械预防19.8% vs. 12.6%，药物预防0.9% vs. 0.2%）。两组均未发生危及生命的出血病例。结论：应用护理辅助早期预警干预是预防CD后静脉血栓栓塞的有效方法。
Effect of Nurse-Assisted Early Warning Intervention for Prevention of Venous Thromboembolism Following Cesarean Delivery.
Objective: To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism (VTE) and preventing VTE following cesarean delivery (CD).
Methods: A prospective cohort study conducted between January 1, 2020, and December 30, 2022, enrolled pregnant women who underwent CD in the obstetric unit of Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital. The patients were assigned to a control group (routine nursing care) or the intervention group (nurse-assisted early warning intervention) depending on whether or not the nurse-assisted early warning intervention had been implemented. The χ2 test and Student's t-test were used for statistical analysis. The primary outcome was the incidence of systemic VTE following CD, and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis.
Results: A total of 27,074 cases were enrolled. The incidence of symptomatic VTE following CD was significantly lower in the intervention group (0.29 per 1000 deliveries) than in the control group (2.4 per 1000 deliveries) (P < 0.001). Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group (respectively, 19.8% vs. 12.6% receiving mechanical prophylaxis and 0.9% vs. 0.2% receiving pharmacological prophylaxis). No cases of life-threatening bleeding occurred in either group.
Conclusion: The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.
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