急性期下肢深静脉血栓形成患者早期下床活动的Meta分析  

Meta-analysis of early ambulation for patients with acute deep venous thrombosis of lower extremities

作　　者：徐元玲[1] 沈云[1] 李永生[1] 刘利彪 Xu Yuanling;Shen Yun;Li Yongsheng;Liu Libiao(Department of Vascular Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Eastern China Institute of Digital Medical Engineering,Shangrao 334000,China)

机构地区：[1]安徽医科大学第一附属医院血管外科,合肥230022 [2]华东数字医学工程研究院,江西上饶334000

出　　处：《中国血管外科杂志（电子版）》2021年第2期130-134,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：江西省重点研发计划项目(20192BBGL70049)。

摘　　要：目的探讨急性期下肢深静脉血栓患者早日下床活动的效果,为临床实践提供循证依据。方法系统性检索Cochrane Library、JBI、Pubmed、Medline、EM base、中国生物医学文献数据库、中国知网、万方数据库和维普数据库从建库至2020年1月关于下肢深静脉血栓患者急性期早期活动与卧床休息的临床对照试验,使用RevMan 5.3软件进行对符合标准的研究进行Meta分析。结果共纳入11篇文献进行Meta分析,共2919例患者。Meta分析结果显示,相比卧床休息,下肢深静脉血栓急性期患者早期下床活动继发肺栓塞的发生率差异有统计学意义(相对危险度0.66,95%CI=0.49~0.94,P=0.02),但在患者患肢肿胀缓解方面差异无统计学意义(P=0.49)。结论下肢深静脉血栓急性期患者早日下床活动不增加肺栓塞的发生率,但可能不能明显缓解患肢肿胀问题。Objective To explore the effect of early ambulation for the patients with acute deep venous thrombosis of lower extremities,and to provide evidence-based basis for clinical practice.Methods We systematically searched databases including Cochrane Library,JBI,PubMed,MEDLINE,EM base,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang database and VIP database to collect clinical controlled trials of early activity and bed rest in patients with acute deep venous thrombosis of lower extremity from the establishment of the database to January 2020.Meta-analysis was conducted with RevMan 5.3 software.Results A total of 11 literatures with 2919 patients were included.The results of Meta-analysis showed that the incidence of pulmonary embolism in patients with acute deep vein thrombosis of lower extremities with early ambulation was statistically significant compared with bed rest(relative risk was 0.66,95%CI=0.49~0.94,P=0.02).However,there was no significant difference in the reduction of limb swelling(P=0.49).Conclusion Early ambulation for patients with acute deep venous thrombosis of lower extremities does not increase the incidence of pulmonary embolism,but it may not significantly alleviate the reduction of limb swelling.

关 键 词：深静脉血栓形成 肺栓塞 卧床休息 下床活动 META分析 

分 类 号：R543.6[医药卫生—心血管疾病]