简介：摘要目的探讨全髋关节置换(THA)术后深静脉血栓形成(DVT)基于健康信念模式的健康教育在减少THA后DVT发生的价值.方法从２０１０年１月~２０１４年１月中选取行THA手术的患者１２０例,按照随机数字表法分为实验组和对照组各６０例,对照组给予THA术后常规护理干预包括DVT相关知识健康宣教、功能锻炼、物理预防、药物预防四项.实验组在对照组的基础上给予基于健康信念模式的术前健康教育.观察两组患者的干预前后DVT基本知识评分、健康信念评分、术后功能锻炼开始时间及依从性、DVT相关症状发生情况、凝血功能、D－二聚体水平、蛋白S、蛋白C及超声检查结果.结果干预后实验组患者的DVT基本知识评分和健康信念评分明显高于对照组.实验组平均术后功能锻炼开始时间为(０??６２±０??２４)天,对照组为(１??７６±０??７２)天,实验组明显早于对照组.实验组术后功能锻炼依从性优良率为９０??０％(５４/６０),对照组为５３??３％(３２/６０),实验组明显优于对照组.实验组肢体周径及体表温度、Homan征及Neuhof征发生率明显低于对照组,血浆D－二聚体水平明显低于对照组,差异具有统计学意义(P＜０??０５).两组的蛋白C活性、蛋白S活性、凝血功能指标比较差异无统计学意义(P＞０??０５).干预后实验组超声检查发现１例(１??６７％)血流瘀滞,无DVT病例,对照组有７例(１１??６７％)血流瘀滞,３例(５??０％)DVT;两组均未发生肺栓塞,实验组血流瘀滞及DVT发生率明显低于对照组,差异具有统计学意义(P＜０??０５).结论基于健康信念模式的术前健康教育可有效的提高患者的依从性,可显著降低THA术后DVT的发生风险.关键词全髋关节置换术;深静脉血栓;危险因素;健康信念模式;健康教育AbstractObjectiveThevalueofpreoperativehealtheducationbasedonthehealthbeliefmodelinreducingtheincidencerateofDVTafterTHA??Methods１２０caseswereselectedfromJan??２０１０－Jan??２０１４,whichweredividedintoexperimentgroupandcontrolgroup(both６０cases)randomly??ThecontrolgroupwasgivenTHAroutinenursingintervention,includinghealtheducation,functionalexercise,physicalanddrugprevention??Theexperimentgroupwasgiventhepreoperativehealtheducationbasedonthehealthbeliefmodelexcepttheroutineinterventionofcontrolgroup??DVTbasicknowledgescores,healthbelieflevelrating,postoperativefunctionexercisestarttimeandthetreatmentcompliance,theincidenceofDVTsymptoms,bloodcoagulationfunction,D－dimerlevel,proteinCandSandtheultrasonicexaminationofthetwogroupswereobservedbeforeandaftertheintervention??ResultsTheDVTbasicknowledgescoreandhealthbelieflevelratingoftheexperimentgroupafternursinginterventionweresignificantlyhigherthancontrolgroup??TheaveragepostoperativefunctionexerＧcisestarttimeofexperimentgroup(０??６２±０??２４d)wasobviouslyearlierthancontrolgroup(１??７６±０??７２d)??Thegoodrateofcomplianceofpostoperativefunctionexerciseinexperimentgroup(５４/６０,９０??０％)wasobviouslybetterthancontrolgroup(３２/６０,５３??３％)??TheperimeterandsurfacetemperatureofthelowerlimbsandtheincidenceratesofHomansignandNeuhofsignandD－dimerlevelinexperimentgroupwassignificantlylowerthanthecontrolgroup(P＜０??０５)??