護理師照護一位全髖關節置換術後的病人。護理師應採取哪項措施以預防深部靜脈栓塞？
A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which action should the nurse take to prevent deep vein thrombosis?
- AMassage the lower extremities to improve circulation按摩下肢以改善循環
- BApply sequential compression devices as prescribed✓ 正解依醫囑使用間歇性氣壓加壓裝置
- CElevate the knees by placing a pillow underneath在膝蓋下方放置枕頭以抬高膝蓋
- DKeep the client on strict bed rest for 48 hours讓病人嚴格卧床休息 48 小時
全髖關節置換術（Total Hip Arthroplasty, THA）後的病人因手術創傷、長期臥床及止痛藥使用，屬於深部靜脈栓塞（DVT）的高風險群。預防策略應著重於促進靜脈回流、減少血液淤滯。機械性壓迫設備（SCDs）透過週期性充氣壓迫，能有效模擬肌肉幫浦功能，加速下肢深層靜脈血流。臨床思路應優先採取非侵入性且實證有效的預防措施，同時鼓勵早期活動與抗凝血藥物治療。
Sequential compression devices (SCDs) should be applied as prescribed to promote venous return and prevent blood stasis in the lower extremities. Massaging the legs is contraindicated as it may dislodge a potential clot, while elevating the knees can impede circulation. Early ambulation is preferred over prolonged bed rest to reduce the risk of deep vein thrombosis.
在美國臨床實務中，SCDs 的使用頻率極高且有嚴格的 compliance 監測（通常要求每日使用 18 小時以上）。台灣醫院亦廣泛使用，但需注意護理師在美國需更強調病人教育，確保病人理解為何不能自行移除裝置。