膝关节置换术后并发深静脉血栓病人溶栓期间的出血预测方案构建

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Abstract  Objective：To construct early prediction scheme for bleeding in patients with deep vein thrombosis（DVT） after total knee arthroplasty（TKA） during thrombolysis.Methods：Based on literature review，clinical practice observation，and repeated group discussion，the first draft of early prediction scheme for bleeding in patients with DVT after TKA during thrombolysis was formed.The final version of early prediction scheme for bleeding in patients with DVT after TKA during thrombolysis was determined through two rounds of expert correspondence.Results：The recovery rate of two rounds of expert correspondence questionnaires both were 100%.The rate of expert brought up opinions were 57.89% and 47.37%，respectively.The expert authority coefficients were 0.862 and 0.875，respectively.The coefficient of variation were from 0.045 to 0.313 and from 0.023 to 0.233，respectively.And Kendall's W values were 0.246 and 0.145，respectively.In the second round of expert correspondence，the average score of importance of the first⁃level indicators were from 4.34 to 4.97，and the full score rate were from 44.74% to 97.37%.The average score of importance of the second⁃level indicators were from 4.18 to 4.68，and the full score rate were from 36.84% to 68.42%.The average score of importance of the third⁃level indicators were from 4.26 to 4.95，and the full score rate were from 26.32% to 94.74%.Finally，early prediction scheme for bleeding in patients with DVT after TKA during thrombolysis was formed，including 4 first⁃level indicators，11 second⁃level indicators and 31 third⁃level indicators.Conclusions：The early prediction scheme for bleeding in patients with DVT after TKA during thrombolysis constructed in this study is scientific and clinically applicable，which can provide reference for clinical staff to prevent bleeding risk during thrombolytic therapy and ensure patient safety.

Keywords    total knee arthroplasty； deep vein thrombosis； thrombolysis； bleeding； risk management； Delphi method；nursing

摘要  目的：构建膝关节置换术（TKA）术后并发深静脉血栓（DVT）病人溶栓期间的出血预测方案。（剩余12151字）