不同频次使用间歇式充气加压装置对预防关节置换术后下肢深静脉血栓形成的效果研究  

Efficacy of intermittent pneumatic compression in different modes to prevent deep vein thrombosis after total joint arthroplasty

作　　者：张竞[1] 张金庆[1] 郭盛杰[1] 王丹丹[2] 吴坚[1] ZHANG Jing ZHANG Jinqing GUO Shengjie WANG Dandan WU Jian(Department of Orthopedics Department of Ultrasound Diagnosis, Beij ing JiShuiTan Hospital, Beijing 100035, China)

机构地区：[1]北京积水潭医院矫形骨科,北京100035 [2]北京积水潭医院超声诊断科,北京100035

出　　处：《中国骨与关节外科》2016年第4期335-338,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景：关节置换手术后预防下肢深静脉血栓形成（DVT）的物理治疗方式多样,临床医护人员急待明确可降低DVT发生率的有效方法。本研究两种不同频次治疗方式均可降低。DVT发生率,临床医护人员可根据患者特点选择合理的方式进行物理治疗。目的：探讨不同频次使用间歇式充气加压装置（IPC）预防关节置换术后患者下肢DVT的效果。方法：将2013年12月至2014年9月入院行关节置换术患者160例随机分为对照组和观察组各80例,两组患者基线资料无统计学差异。两组患者术后第1日均给予穿抗血栓压力带、口服抗凝药物等常规防血栓治疗。对照组患者于术后第1日使用IPC,使用频次为每日上午2 h：观察组患者于术后第1日使用IPC,使用频次为每日上、下午各1 h。两组患者均于术后3-5 d常规行双下肢深静脉彩超,观察下肢DVT发生情况。结果：观察组患者7例发生下肢DVT,占8.75%,肌间血栓24例,占30%;对照组患者5例发生下肢DVT,占6.25%,肌间血栓占20例,占25.0%。两组患者下肢DVT发生率无统计学差异（P〉0.05）。结论：不同频次使用IPC对预防关节置换术后下肢DVT的效果相同,但每日上午2 h集中使用IPC可降低医务工作者的工作量,同时使患者有充足的时间进行术后康复训练,更不会延误术后各项检查的筛查工作,有助于提高住院期间的满意度。Background：There are many physiotherapies for the prevention of deep vein thrombosis（DVT） after total joint arthroplasty（TJA）.It needs urgently to identify proper physical therapy according to the patient characteristics.Objective：To investigate the efficacy of intermittent pneumatic compression（IPC） in two modes to prevent DVT after TJA.Methods：A total of 160 patients who underwent TJA from December 2013 to September 2014 were randomly divided into control group and observation group（n=80）.There was no significant difference in the baseline information between the two groups.Pressure belts,anticoagulants and IPC were used in both groups since the first postoperative day.In the control group IPC was used once a day for 2 h,but in the observation group IPC was used twice a day and 1 hour for one time.Ultrasound was done at 3-5 postoperative day to detect whether there was DVT or not.Results：DVT occurred in 7 patients（8.75%） and intramuscular vein thrombosis in 24 patients（30%） in the observation group.DVT occurred in 5 patients（6.25%） and intramuscular vein thrombosis in 20 patients（25.0%） in the control group.There was no significant difference in the incidence of DVT between the two groups（P〈0.05）.Conclusions：There are similar efficacies of IPC in the two modes to prevent DVT after TJA.But IPC used once a day for 2 h can reduce workload of medical staff and make patients have sufficient time for postoperative rehabilitation.

关 键 词：关节成形术 置换 深静脉血栓 物理治疗 

分 类 号：R473.6[医药卫生—护理学]