【摘要】 目的 探讨分级干预对头颈部肿瘤术后PICC患者静脉血栓及凝血功能的影响。方法 对头颈部肿瘤术后PICC置管患者使用相同的血栓风险评估表筛查风险等级，将血栓风险等级中的中风险、高风险分别排序号，设单号为观察组，双号为对照组，各92例，其中中风险、高风险分别46例。对照组两个风险等级均给予常规护理；观察组中风险者，给予常规护理加特定电磁波，高风险者在中风险护理基础上，加用红花酒精外敷置管静脉皮肤投影区。比较两组患者血浆D-二聚体（D-D）、纤维蛋白原（FIB）及凝血酶原时间（PT）、活化部分凝血活酶时间（APTT)及血栓发生率。结果 干预后，观察组中风险及高风险等级患者FIB指标低于对照组，PT及APTT指标较对照组延长，但在正常范围内，组间比较差异具有统计学意义（均P<0.05）；观察组中风险患者D-D指标比较差异无统计学意义（P>0.05）,高风险患者D-D指标低于对照组（P<0.05）。观察组血栓发生率为11.96%，对照组为29.35%，均主要发生于高风险等级，两组血栓发生率比较，差异有统计学意义（P<0.05）。结论 头颈部肿瘤术后患者PICC置管后按血栓风险等级实施护理干预，可有效降低血液高凝状态，从而降低血栓发生率。更多还原

【Abstract】 Objective To investigate the effect of graded intervention on venous thrombosis and coagulation function in patients with PICC after head and neck tumor surgery. Methods To use the same thrombosis risk assessment table was implemented to screen the risk level of patients with PICC catheterization after head and neck tumor surgery, and the medium risk and high risk in the thrombosis risk level were ranked respectively, and the odd number was the observation group, and the double number was the control group, with 92 cases in each group, including 46 cases of medium risk and 46 cases of high risk. The control group was given routine nursing for both risk levels; the observation group was given routine nursing plus specific electromagnetic waves for medium-risk patients, and the high-risk patients were additionally given safflower alcohol to apply externally to the skin projection area of the vein on the basis of medium-risk nursing to compare the plasma D-dimer(D-D),fibrinogen(FIB), prothrombin time(PT), activated partial thromboplastin time(APTT) and the incidence of thrombus in the two groups. Results After the intervention, the FIB index of patients with medium-risk and highrisk grades in the observation group was lower than that of the control group, and the PT and APTT indexes were longer than those in the control group, but within the normal range, and the differences between the groups were statistically significant(all P<0.05). There was no significant dif ference in the D-D index of the middle-risk patients in the observation group(P>0.05), and the D-D index of the high risk patients was lower than that of the control group(P<0.05). The incidence of thrombosis in the observation group was 11.96% and that in the control group was 29.35%, both of which mainly occurred in high-risk groups, and there was a statistically significant dif ference in the incidence of thrombosis between the two groups(P<0.05). Conclusions Nursing intervention according to the thrombosis risk level after PICC cannulation in patients with head and neck tumor surgery can effectively reduce the hypercoagulable state of blood, thereby reducing the incidence of thrombosis.更多还原