动静脉脉冲系统与低分子肝素钙联合应用预防全膝关节置换术后深静脉血栓  

A COMBINATION OF ARTERIOVENOUS IMPULSE SYSTEM AND LOW-MOLECULAR-WEIGHT HEPARINS CALCIUM FOR PROPHYLAXIS OF DEEP VENOUS THROMBOSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

作　　者：曹娟[1] 王金玲[2] 张环[3] 王丽丽[2] 

机构地区：[1]潍坊医学院附属医院骨二科,山东潍坊261031 [2]潍坊医学院附属医院肾内科,山东潍坊261031 [3]潍坊医学院附属医院眼科,山东潍坊261031

出　　处：《中国修复重建外科杂志》2010年第5期538-540,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结动静脉脉冲系统联合低分子肝素钙预防人工全膝关节置换术(total knee arthroplasty,TKA)术后深静脉血栓形成的效果。方法2006年3月-2008年3月,对76例(76膝)骨性关节炎患者行TKA。男25例,女51例;年龄58～79岁,平均66.6岁。左侧41例,右侧35例。患者根据预防下肢深静脉血栓发生的处理方式不同分为实验组和对照组。两组患者术前及术后常规应用低分子肝素钙,此外实验组术后1～4d不间断应用动静脉脉冲系统,术后5～7d每日应用2次,30min/次。术后7d患者均行彩色超声多普勒探查下肢深静脉血栓发生情况。结果实验组发生小腿深静脉血栓5例,发生率13.16%,经给予尿激酶、丹参等药物治疗后完全消失;对照组发生小腿深静脉血栓11例,全下肢深静脉血栓3例,发生率36.84%,经同样治疗后好转。两组深静脉血栓发生率差异有统计学意义(P<0.05)。两组均无继发肺栓塞及死亡发生。结论动静脉脉冲系统可有效加速下肢静脉血液回流速度,与低分子肝素钙联合应用较单纯应用低分子肝素钙对预防TKA术后下肢深静脉血栓形成有更好的效果。Objective To analyze the effect of arteriovenous impulse system （AVIS） combined with low-molecular-weight heparins calcium （LMWHC） for prophylaxis of deep vein thrombosis （DVT） following total knee arthroplasty （TKA）. Methods From March 2006 to March 2008,76 cases of osteoarthritis patients （76 knees） accepted TKA,including 25 males and 51 females with an average age of 66.6 years （range,58-79 years）. The affected knees were left side in 41 cases and right side in 35 cases. They were randomly divided into experimental group and control group before surgery. Then LMWHC and rehabilitation training were routinely given in two groups before and after surgery. However,only experimental group was treated with AVIS continually during the first four days and then two times a day for 30 minutes one time during 5-7 days. At 7 daysd after operation,color Doppler ultrasound was used to detect the occurrence condition of DVT. Results Five cases （13.16%） had thrombosis of calf and recovered after treated with urokinase and salvia in the experimental group. Eleven cases had thrombosis of calf and 3 cases had thrombosis of whole low extremities （36.84%）,and improved after treated with urokinase and salvia in the control group. There was signifi cant difference in DVT incidence rate between two groups （P 〈0.05）. No pulmonary embolism or death was found in both groups. Conclusion AVIS can effectively accelerate the venous blood return velocity,a combination of AVIS and LMWHC has a better effect in the prevention of DVT following TKA.

关 键 词：全膝关节置换术 深静脉血栓 动静脉脉冲系统 低分子肝素钙 

分 类 号：R687.4[医药卫生—骨科学] R654.3[医药卫生—外科学]