温针灸结合低分子肝素钙对ICU患者下肢静脉血栓形成的影响  

Effect of warm acupuncture combined with low molecular weight heparin calcium on the venous thrombosis of lower extremities in ICU patients

作　　者：谢敏飞 杨英姿[1] 刘莹莹[1] XIE Minfei;YANG Yingzi;LIU Yingying(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province,Linhai 317000,China)

机构地区：[1]浙江省台州医院重症医学科,浙江临海317000

出　　处：《中国现代医生》2020年第21期31-34,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2019ZB141)。

摘　　要：目的探讨温针灸结合低分子肝素钙对ICU患者下肢静脉血栓形成的影响。方法对照组2017年1~12月共纳入患者348例,采用常规低分子肝素钙预防下肢静脉血栓形成;观察组2018年1~12月共纳入患者362例,采用温针灸联合低分子肝素钙预防下肢静脉血栓形成。比较两组下肢静脉血栓发生率,治疗前、后股总静脉管腔直径及最大血流流速,股总静脉平均血流速度,D-二聚体、纤维蛋白原、内皮素-1、凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、血清缺氧诱导因子1α(HIF-1α)水平及不良反应。结果(1)观察组血栓形成发生率显著低于对照组,差异有统计学意义(P<0.05)。(2)治疗后两组股总静脉直径较治疗前显著下降,血液最大流速、平均流速较治疗前显著增加,差异有统计学意义(P<0.05);治疗后观察组股总静脉直径显著低于对照组,血液最大流速与平均流速显著高于对照组,差异有统计学意义(P<0.05)。(3)治疗后两组纤维蛋白原、D-二聚体、内皮素-1、HIF-1α水平较治疗前显著下降,差异有统计学意义(P<0.05);治疗后观察组纤维蛋白原、D-二聚体、内皮素-1、HIF-1α水平显著低于对照组,差异有统计学意义(P<0.05)。(4)两组治疗前APTT、PT、TT水平比较差异无统计学意义(P>0.05)。两组治疗后APTT、PT、TT有所延长,但与治疗前比较差异无统计学意义(P>0.05)。(5)两组均无严重不良反应发生。结论温针灸结合低分子肝素钙可显著降低ICU患者下肢静脉血栓发生率,改善股总静脉血流动力学指标。Objective To investigate the effect of warm acupuncture combined with low molecular weight heparin calcium on the venous thrombosis of lower extremities in ICU patients.Methods A total of 348 patients who were enrolled from January to December in 2017,and were given conventional low molecular weight heparin for prevention were selected as the control group.A total of 362 patients who were enrolled from January to December in 2018,and were given warm acupuncture combined with low molecular weight heparin for prevention were selected as the observation group.The incidence rate of venous thrombosis in the lower extremities,the lumen of common femoral veins before and after treatment,the maximum blood flow rate,the mean blood flow rate of the common femoral vein,D-dimer,fibrinogen,endothelin-1 level,activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),serum hypoxia-inducible factor 1α(HIF-1α)and adverse reactions were compared between the two groups.Results(1)The incidence rate of thrombosis in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the diameter of common femoral veins in the two groups was significantly lower than that before treatment.The maximum blood flow rate and mean blood flow rate were significantly higher than those before treatment.The differences were statistically significant(P<0.05);after treatment,the diameter of common femoral veins in the observation group was significantly lower than that in the control group,and the maximum blood flow rate and mean blood flow rate were significantly higher than those in the control group.The differences were statistically significant(P<0.05).(3)The levels of fibrinogen,D-dimer,endothelin-1 and HIF-1αin the two groups after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05);after treatment,the levels of fibrinogen,D-dimer,endothelin-1 and HIF-1αin the

关 键 词：温针灸 低分子肝素钙 ICU 下肢静脉血栓 

分 类 号：R364.1[医药卫生—病理学]