周期性充气加压预防髋部骨折老年患者术后下肢深静脉血栓的效果  

Effect of intermittent pneumatic compression on venous thrombosis prevention in elder patients with hip fracture deep after operation

作　　者：宫瑜[1] 于红[1] 

机构地区：[1]中国医科大学附属盛京医院第二骨科脊柱外科,沈阳110001

出　　处：《中华现代护理杂志》2013年第22期2715-2718,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨周期性充气加压（IPC）对老年髋部骨折患者手术后下肢深静脉血栓的预防价值。方法选择接受髋部骨折手术的老年患者87例，随机分为两组，对照组43例给予常规术后护理及药物预防；IPC组44例在对照组预防措施基础上加用周期性充气加压。观察患者术后第3，7，14天D-二聚体变化和下肢周径差值变化，比较两组患者术后下肢深静脉血栓发生率。结果两组患者术后下肢周径差值在第3天时差异无统计学意义（P〉0．05）；D-二聚体含量在第7，14天时差异均无统计学意义（P〉0．05）；IPC组术后下肢周径差值第7天（2．8698±0．8887）cm，第14天（3．3558±0．9064）cm，均小于对照组，差异有统计学意义（t值分别为-2．871，-2．702；P〈0．01）。术后第3天D-二聚体含量IPC组（0．6498±0．2175）ng／L，对照组（0．7541±0．2380）ng/L，两组比较差异有统计学意义（t=-2．133，P〈0．05）。IPC组DVT发生率为13．95％（6／43），对照组31．82％（14／44），差异有统计学意义（x。=3．920，P〈0．05）；两组患者并发症发生情况比较差异无统计学意义（P〉0．05）。结论周期性充气加压可明显缓解患者下肢肿胀，降低D-二聚体含量，具有明显的血栓预防效果。Objective To evaluate the safety and efficacy of intermittent pneumatic compression （IPC） in prevention of deep venous thrombosis （DVT） after orthopedic operation of hip fracture in elder patients. Methods From Aug 2007 to Dec 2010, 87 patients were assigned randomly into IPC group （ n = 44） and control group （ n = 43）. Patients received regular DVT prevention in the control group. In the IPC group, IPC was added to the prevention strategy same to control group. The differences of lower limb circumferences and D - dimer in blood plasma of all the patients were tested in the 3th day, 7th day and 14th day after surgery. The DVT rates of both groups were accessed by color Doppler ultrasound. Results No significant difference of lower limb circumferences was found between IPC group and control group in the 3th day after the operation （P 〉 0.05）. The circumference differences of lower limbs in IPC group were significantly smaller than the control group in 7th day and 14th day after the surgery [ （2. 8698 ± 0.8887 ） vs （3. 3558± 0.9064） cm; t = -2.87 1, -2. 702;P 〈0.011. The D-dimer of patients in IPC group was significantly lower than control group in 3th day [ （0.6498 ± 0.2175 ） vs （0.7541 ± 0.2380） ng/L; t = - 2.133, P 〈 0.05 ]. There were 20 patients developed DVT, with 14 cases in control group and 6 cases in IPC group. The DVT rate of IPC group was significantly lower than that of control group （ 13.95% vs 31.82% ; X2 = 3. 920, P 〈 0. 05 ）. Conclusions This study confirmed the efficacy and safety of the addition of IPC to regular prevention in DVT prophylaxis for elder patients after surgery of hip fracture.

关 键 词：老年 髋部骨折 周期性充气加压装置 静脉血栓 

分 类 号：R473.6[医药卫生—护理学]