— 降低風險 · EASY · MCQ —
護理師照護一位髖關節置換術後病人，哪項介入措施對於預防深層靜脈血栓（DVT）最有效？
A nurse is caring for a client who is post-operative following a hip arthroplasty. Which intervention is most effective in preventing deep vein thrombosis (DVT) in this client?
- AMaintaining strict bed rest for 48 hours嚴格卧床休息 48 小時
- BApplying warm compresses to the lower extremities在下肢應用熱敷
- CEncouraging early and frequent ambulation✓ 正解鼓勵早期且頻繁的下床活動
- DAssessing pedal pulses every 4 hours每 4 小時評估足背脈搏
— Explanation · 中文詳解 —
術後早期下床活動可利用小腿肌肉幫浦作用，促進血液回流，防止深層靜脈瘀積。這是預防血栓最自然且有效的物理性措施。熱敷可能造成燙傷或血管擴張風險，嚴格臥床反而會增加血液瘀積風險，而評估脈搏僅為監測，無法預防。
Early postoperative ambulation uses the calf muscle pump effect to promote venous return and prevent deep venous stasis. This is the most natural and effective physical measure for preventing thrombosis. Warm compresses risk burns or vasodilation, strict bed rest actually increases the risk of stasis, and pulse assessment is monitoring only and does not prevent thrombus formation.
✦ 台美臨床差異
美國醫院有嚴格的術後早期下床 Protocol，台灣部分醫師傾向要求臥床較久以防傷口出血，觀念正逐漸與國際接軌。