物理疗法联合低分子肝素预防重症急性胰腺炎患者下肢深静脉血栓的临床研究  

Physical therapy combined with low molecular weight heparin in prophylaxis of deep vein thrombosis in patients with severe acute pancreatitis

作　　者：符海燕[1] 万兵[2] 徐芳[3] 尹江涛[3] 王芝[2] 

机构地区：[1]江苏大学附属医院普通外科,镇江212001 [2]江苏大学附属医院急诊医学中心,镇江212001 [3]江苏大学附属医院重症监护室,镇江212001

出　　处：《山西医药杂志》2014年第9期986-988,共3页Shanxi Medical Journal

基　　金：镇江社会发展科技支撑项目(SH2013037);江苏大学医学临床科技发展基金(JLY20120164)

摘　　要：目的探讨间歇充气加压泵(IPC)联合低分子肝素预防重症急性胰腺炎下肢深静脉血栓形成(DVT)的有效性。方法对100例危重患者按入住重症监护室(ICU)的先后顺序随机分成综合预防组和对照组,每组50例,除疾病所需治疗外,从第1天起,综合预防组使用IPC联合低分子肝素钙皮下注射抗凝,对照组使用常规护理方法预防血栓,第1、3、7、14天对2组患者行彩色多普勒超声或CT检查,观察下肢DVT发生情况。结果综合预防组1例(2%)发生下肢DVT;对照组8例(16%)发生下肢DVT,DVT发生率2组比较差异有统计学意义(P<0.05)。结论 IPC联合低分子肝素钙预防DVT效果显著,值得在重症急性胰腺炎患者中联合使用。Objective To evaluate the efficacy and safety of intermittent pneumatic compression pump combined with low molecular weight heparin in prophylaxis of deep vein thrombosis （DVT） in patients with severe acute pancreatitis （SAP） in ICU. Methods One hundred critically-ill patients admitted to the ICU were randomly divided into combination group （intermittent pneumatic compression pump combined with LMWH） and control group, 50 patients in each group. In addition to required treatment for disease, from day 1, intermittent pneumatic compression pump combined with LMWH were used for the patients in combination group. The patients of control group received usual care. Color Doppler ultrasound or CT scan was performed at day 1,3,7 and 14. The incidence of DVT would be observed and recorded. Results Of 100 patients, 1 （2%） lower extremity DVT developed in combination group, no pulmonary embolism （PE） and no complications developed. Eight （16%） lower extremity DVT developed in control group. There was statistically significant difference of the incidence of DVT between the two groups （P〈0.05）. Conclusion Combination of physiotherapy （intermittent pneumatic compression pump） and LMWH may be a practical prophylaxis of DVT for criticallyqll patients with SAP in ICU.

关 键 词：静脉血栓形成 胰腺炎 急性坏死性 肝素 低分子量 

分 类 号：R657.51[医药卫生—外科学]