ผลของโปรแกรมการป้องกันลิ่มเลือดอุดตันหลอดเลือดดำส่วนลึกต่อความเร็วในการไหลเวียนของเลือดดำและสัดส่วนการเกิดลิ่มเลือดอุดตันหลอดเลือดดำส่วนลึกในผู้ป่วยวิกฤตศัลยกรรม

Abstract

Deep vein thrombosis in critically ill patients is a harmful complication. It induces pulmonary embolism and sudden death. Nurses have an important role to improve venous circulation in femoral vein to reduce the risk of this condition. This experimental study, using a pretest-posttest control group and convergent parallel design, aimed to examine the effect of a deep vein thrombosis prevention program on venous blood flow velocity and deep vein thrombosis ratio among critically ill surgical patients. Data was collected from critically ill surgical patients who had a moderate to high risk of deep vein thrombosis (Autar deep vein thrombosis risk assessment score > 11). Simple random sampling by lottery was used to assigned 50 participants into an experimental or a control group with 25 participants in each group. The research instrument was composed of 1) the deep vein thrombosis prevention program for critically ill surgical patients, and 2) the outcomes instrument composed of a venous blood flow velocity record form, which was measured by doppler ultrasound, and a deep vein thrombosis record form. Descriptive statistics and repeated measurement analysis of variance (ANOVA) were used for data analysis.

The results revealed that: 1. The mean of femoral venous blood flow velocity in the control group on day 1, day 3, and day 6 showed no difference (p = 1.00) but was statistically significantly different in the experimental group between day 1 and day 6, and day 3 and day 6 (p = .001 and p = .004). 2. The means of femoral venous blood flow velocity between the control group and the experimental group were statistically significantly different (p = .001) for all three days of measurement (day 1, day 3, and day 6). 3. There was no deep vein thrombosis incidence in either group. The results of this study show that implementation of this program can increase femoral venous blood flow velocity, which can prevent deep vein thrombosis among critically ill patients.