ABSTRACT
Objective:To investigate the preventive effect of different intermittent pneumatic compressiondevices (IPC) schemes on deep vein thrombosis (DVT) of lower extremity in patients with status epilepticus (SE), to provide nursing basis for rational application of IPC in early admission of SE patients.Methods:A similar experimental study was conducted and 76 SE patients in the intensive care unit of the Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2018 to May 2022 were selected by convenience sampling method. The 35 SE patients hospitalized from January 2018 to February 2020 were included in the control group, and 41 patients hospitalized from March 2020 to May 2022 were included in the intervention group.Both groups were given anti-seizure medications (ASMs) to actively control seizures after admission.IPC application frequency and duration in control group were twice a day, 1 hour each time; the frequency of IPC application in the intervention group was once a day for greater than or equal to 12 hours each time.The incidence of lower limb DVT, epileptic seizure, abnormal electroencephalogram discharge and coagulation index related to lower limb DVT formation were compared between the two groups.Results:There was no significant difference in the indexes of fibrinogen, D-dimer and thrombin time between the two groups of SE patients at admission ( P>0.05). At discharge, the indexes of fibrinogen, D-dimer and thrombin time were (4.02 ± 1.71) g/L, 7.06(5.33, 15.01) mg/L and 10.22(7.53, 14.42) s in the intervention group respectively, which were lower than (4.98 ± 1.62) g/L, 11.92(5.75, 15.26) mg/L and 17.96(13.21, 28.14) s in the control group, the differences were statistically significant ( t = 3.03, Z = 4.32, 1.56, all P<0.05). The DVT incidence rate was 62.86% (22/35) in the control group, and the intervention group was 12.20% (5/41). The difference was statistically significant ( χ2 = 21.59, P<0.01). Conclusions:On the basis of effective control of clinical seizures in SE patients treated with ASMs, early IPC use and daily treatment time at least 12 hours can avoid induced seizures, reduce the formation and risk of lower extremity DVT, and improve blood hypercoagulability.
ABSTRACT
Objective:To explore the application effect of optimizing the anti-epileptic drug (AED) administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods:A quasi-experiment study was conducted by convenience sampling. The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group .The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group .The experimental group was implemented the optimized administration procedure after ICU admission. The control group was implemented the routine administration procedure after ICU admission. Some data of the two groups were compared, including baseline data, first administration time after admission, administration step time, AED dose reserve, and seizures at different time periods and so on.Results:Comparative analysis of the time of the first drug administration after admission into the two groups .The administration time of the control group was 31.0 (10.0-69.0) min, which was significantly longer than that of the experimental group, 25.0 (16.0-31.8) min ( χ2 value was -2.760, P<0.05). Comparison and analysis of the time taken for each step of drug administration: The time taken for step 1(Patient admission—medical order confirmation) in the control group was significantly greater than that in the experimental group ( χ2 value was -2.811, P<0.05); step 2 (medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group ( χ2 value was -4.327, P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups ( χ2 value was -1.137, P>0.05). Control group AED reserve ratio 63.6% (28/44), experimental group AED reserve was 100.0% (44/44), and the difference was statistically significant ( χ2 value was 19.556, P<0.05). Epilepsy control in two groups of patients: the total control rate after the first administration of the experimental group was 93.2% (41/44), which was significantly higher than 61.4% (27/44) of the control group ( Z value was -3.445, P<0.001). Conclusion:It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.