Special Topics:Enhanced Recovery After Surgery Nursing
Effects of enhanced recovery nursing on early postoperative vein thromboembolism risk after pancreaticoduodenectomy
Danping Song, Ruiming Zhang, Weinan Liu, Yawen Ye, Ting Sun, Xiaoming Peng
Published 2019-01-16
Cite as Chin J Mod Nurs, 2019, 25(2): 141-145. DOI: 10.3760/cma.j.issn.1674-2907.2019.02.003
Abstract
ObjectiveTo explore the effects of enhanced recovery nursing on early postoperative vein thromboembolism (VTE) risk after pancreaticoduodenectomy (PD) .
MethodsUsing convenience sampling method, the 45 cases of PD patients with traditional nursing methods from September 2016 to March 2017 were assigned as the control group, and the 66 cases of PD patients with enhanced recovery nursing from March 2017 to June 2018 were assigned as intervention group. The plasma D-dimer level before operation, immediately after operation, and in different postoperative days (POD) : POD1, POD2, POD3 and POD7 were collected. The D-dimer level and the incidence rates of symptomatic VTE were compared between two groups.
ResultsThe D-dimer values of the intervention group immediately after surgery, POD1, POD2, POD3 and POD7 were (2.74±2.31) , (3.31±2.03) , (3.98±3.10) , (4.30±2.89) and (7.46±3.90) mg/L·FEU. The D-dimer of the control group at each postoperative time point were (2.88±1.92) , (3.77±2.72) , (4.37±2.70) , (4.08±1.81) and (6.85±4.07) mg/L·FEU. The overall D-dimer value of the two groups showed an upward trend after operation, but there was no significant difference between two groups (P>0.05) . Repeated measures analysis of variance showed that there were no differences in between-group effect (F=0.03, P=0.87) or interaction effect (F=1.01, P=0.38) of D-Dimer, while the difference in intra-group effect was statistically significant (F=108.28, P<0.05) . There was no statistical significance in the difference of the incidence rates of symptomatic VTE between two groups (χ2=0.87, P>0.05) .
ConclusionsThe early postoperative VTE risk after PD gradually increased, and the enhanced recovery nursing show no significantly advantage in VTE risk reduction after PD compared to traditional methods.
Key words:
Vein thromboembolism; Pancreaticoduodenectomy; Enhanced recovery; Thrombus risks; D-dimer; Symptomatic thrombosis
Contributor Information
Danping Song
The First Ward of General Surgery Department, Peking Union Medical College Hospital, Beijing 100730, China
Ruiming Zhang
Subject Assessment and Quality Management Center, the First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei 230001, China
Weinan Liu
The First Ward of General Surgery Department, Peking Union Medical College Hospital, Beijing 100730, China
Yawen Ye
The First Ward of General Surgery Department, Peking Union Medical College Hospital, Beijing 100730, China
Ting Sun
The First Ward of General Surgery Department, Peking Union Medical College Hospital, Beijing 100730, China
Xiaoming Peng
The First Ward of General Surgery Department, Peking Union Medical College Hospital, Beijing 100730, China