Not yet recruiting

N/A

80

 

Basic preventive measures: ① The surgical operation should be as gentle and precise as possible to avoid damage to the vein intima; ② Standardize the use of Tourniquet; ③ Raise the affected limb after operation to prevent Deep vein reflux obstruction; ④ Regularly conduct knowledge education on venous thrombosis, encourage patients to roll over frequently, perform early functional exercise, get out of bed activities, take deep breaths, and cough movements; ⑤ Moderate fluid replacement during and after surgery, drinking plenty of water, and avoiding dehydration; ⑥ Suggest patients to improve their lifestyle, such as quitting smoking, quitting alcohol, and controlling blood sugar. Physical prevention measures: use plantar vein pump, intermittent inflation pressure device and gradient elastic socks, etc., use mechanical principle to accelerate the blood flow of lower limb veins, reduce blood retention, and reduce the incidence of postoperative Deep vein thrombosis of lower limb. Drug prevention measures For patients at risk of bleeding, the advantages and disadvantages of preventing the formation of lower limb Deep vein thrombosis and increasing the risk of corridor exit should be weighed. The specific drugs should be selected by the doctor according to the patient's situation. Common drugs include unfractionated heparin, low molecular weight heparin, factor Xa inhibitor and Vitamin K antagonist. Strictly follow the medication instructions and observe at any time for any side effects. ;Patients implemented predictive nursing interventions on the basis of routine prevention in the A group. Preoperative nursing: ① Before the operation, the patient's blood glucose, blood routine, blood lipids, coagulation function and other indicators were evaluated and checked, and the results were analyzed to assess the probability and risk of Deep vein thrombosis after the operation. ② Disease knowledge education: introduce the trigger mechanism of lower limb Deep vein thrombosis and its impact on patients' health, inform patients of the significance of implementing preventive measures, and improve patients' compliance with clinical care. ③ Dietary intervention guidance: Before surgery, try to arrange high calcium, high fiber, and high calorie foods for the patient, with the main staple food being easy to digest. At the same time, pay attention to pairing with some fruits and vegetables, and advise the patient to drink more warm and hot water. ④ Psychological intervention nursing: Nursing staff should communicate more with patients, provide targeted relief and relief for their negative emotions, and try to maintain a good attitude towards treatment. Postoperative care: ① Disease monitoring: Regularly observe the color and temperature of the patient's limb skin every day to improve the monitoring of the dorsal foot artery and peripheral blood circulation. ② Position intervention nursing: Arrange the patient to adopt a supine position, while raising the affected limb by about 20 °, and at the same time, a square soft pillow can be taken and placed under the patient's knee. ③ Drug intervention: For some patients with poor pain tolerance, appropriate pain relief drugs can be given, and patients can be arranged to inject low molecular weight heparin or take Rivaroxaban tablets according to the doctor's advice. ④ Function training intervention guidance: after the anesthetic effect disappears, the nursing staff can guide the patient to perform ankle pump exercise, and the amount of exercise should be determined according to the actual situation of the patient; At the same time, the patient can be arranged to train the contraction ability of Quadriceps in bed, and guide the patient to tighten the muscle with maximum strength for five seconds, and then relax. In addition, nursing staff need to roll over and pat the patient's back every two hours. ;Collaborative nursing was implemented on the basis of routine thrombosis prevention in the A group. Collaborative health education is based on the relevant theories of the "health belief model" to improve health education strategies and measures Face to face health education: Rehabilitation nurses provide face-to-face health education to patients and their families. It will be carried out in two stages. The first stage (cognitive change stage): from admission to 1 day before surgery. The purpose of this stage is to enable patients and their families to master the relevant knowledge of thrombosis prevention, and to face the risk of developing DVT and the hazards after DVT. After the patient is admitted to the hospital, the rehabilitation nurse distributes the "Thrombosis Prevention Health Education Manual" to them, and preliminarily evaluates their mastery of thrombosis prevention knowledge. Rehabilitation nurses use easy to understand language to explain the manual content to patients and their families. The second stage (consolidation and reinforcement stage): The purpose of this stage is to strengthen the patient and family members' mastery of thrombus prevention knowledge, and promote its transformation into standardized, effective, scientific, and autonomous thrombus prevention behaviors. Rehabilitation nurses will understand the difficulties faced by patients in implementing thrombus prevention measures, and further consolidate their understanding of the manual content Multimedia teaching: The research group members create multimedia materials and conduct multimedia teaching after surgery. Combination of "broadcasting" and "speaking": Starting from the first day after surgery, multimedia materials will be played once a day in the ward. The rehabilitation nurse explains the PPT content while playing multimedia materials, and allows patients and family members to discuss with each other. Provide counseling again for patients who still have questions after the explanation. Collaborative function training is based on literature review and expert consultation, and a collaborative function training plan is developed. From 1 day before surgery to the 14th day after surgery, carry out functional exercise according to the plan. ① Collaborative function exercise plan. Develop a functional exercise plan: Based on the characteristics of the patient before and after surgery, develop the methods, content, steps, and standard requirements for functional exercise at each stage of the intervention object. The specific arrangement is shown in Table 1. Create a standard functional exercise video: Two research team members will demonstrate and explain the specific methods, main content, and implementation steps of functional exercise after HA surgery, and record the video. The specific content of exercise at different stages, the frequency of required execution, and the actual frequency of execution Implement collaborative functional exercise. a. Watch functional exercise videos: From 1 day before surgery to the 14th day after surgery, the ward plays functional exercise videos daily for patients, and patients watch the video content under the guidance of rehabilitation nurses. b. Nurses demonstrate and guide collaborative functional exercise: After watching the functional exercise video, rehabilitation nurses guide patients and their families to perform functional exercise according to the functional exercise plan. Nurses promptly correct any irregularities in patients and their families. By guiding, implementing, re guiding, and re implementing, patients can complete the exercise content of this stage on their own, in a standardized manner, and according to requirements. c. Nurses and family members supervise the execution of functional exercise: Nurses supervise daily functional exercise, and rehabilitation nurses record the execution of functional exercise for patients on that day and truthfully fill out the functional exercise execution form. Provide answers and guidance to patients and their families who have questions, and understand the reasons that affect exercise. If the patient is unable to complete the exercise content alone, invite family members to assist in passive exercise and complete the exercise plan for the day. Patients and their families need to be informed that if there are special situations such as severe hip joint pain, lower limb adduction and internal rotation during functional exercise, exercise should be stopped immediately, and medical staff should be notified to promptly understand the reasons for the patient's discomfort and provide necessary treatment ;On the basis of routine thrombosis prevention in the A group, predictive nursing combined with collaborative nursing was implemented.

Shifang People's Hospital; Shifang People's Hospital, Self funded projects

Lower limb deep vein thrombosis

 

 

Recruiting

N/A

178

RoW

Rivaroxaban 10 MG, Xarelto

Chiayi Christian Hospital

Venous Thromboembolism, Arthroplasty

12/25

12/25

Recruiting

N/A

1000

RoW

carotid artery stenting, CAS, carotid endarterectomy, CEA, Aspirin, ASP, Clopidogrel, plavix, Anticoagulant, warfarin, rivaroxaban, dabigatran, any other anticoagulant therapy, Statin, atorvastatin, rosuvastatin, any other statin drugs, PCSK9 inhibitor, Evolocumab, Alirocumab, any other PCSK9 inhibitors

Tongji Hospital

Ischemic Stroke, Large-Artery Atherosclerosis (Embolus/Thrombosis)

12/26

12/28

Not yet recruiting

N/A

850

Europe

Rivaroxaban (Xarelto, BAY59-7939), Standard of care (SOC)

Bayer, Janssen Research & Development, LLC

Venous Thromboembolism, Children Under 2 Years

06/29

06/29

Not yet recruiting

N/A

496

NA

Rivaroxaban, XARELTO

China-Japan Friendship Hospital

Pulmonary Embolism

11/22

05/24

Recruiting

N/A

80

RoW

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

Infections

06/24

06/25