间歇性气压治疗联合个性化护理干预对ICU患者下肢静脉血栓形成的干预作用研究  

Effect of intermittent pneumatic therapy combined with personalized nursing intervention on deep vein thrombosis in ICU patients

作　　者：庞爱军 吕海荣[2] 吕菊萍 PANG Aijun;LV Hairong;LV Juping(Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Critical Care Medicine,Xi′an 710004,China;Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Obstetrics&Gynecology,Xi′an 710004,China)

机构地区：[1]西安市人民医院·西安市第四医院重症医学科,陕西西安710004 [2]西安市人民医院·西安市第四医院妇产科,陕西西安710004

出　　处：《西北国防医学杂志》2021年第7期695-700,共6页Medical Journal of National Defending Forces in Northwest China

基　　金：陕西省社会发展科技攻关项目(2019SF135)。

摘　　要：目的:探究间歇性气压治疗联合个性化护理预防ICU患者下肢深静脉血栓(deep vein thrombosis,DVT)形成的临床应用效果。方法:采用随机数字表法将2019-02~2020-02在我院ICU住院的82例患者随机均分为联合组(n=41)和气压仪组(n=41)。气压仪组在常规护理基础上进行间歇性气压仪干预,联合组在气压仪组的基础上给予个性化护理,两组均连续干预21 d。比较两组患者干预21 d后全血黏度高切水平、全血黏度低切水平、D-二聚体水平、凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、股深静脉、腘静脉、胫后静脉血流速度,并统计两组DVT发生率、发生时间及皮肤相关并发症发生率。结果:联合组全血黏度高切水平、全血黏度低切水平及D-二聚体水平均显著低于气压仪组;两组PT、APTT均短于干预前,联合组缩短程度明显大于气压仪组;联合组股深静脉、腘静脉及胫后静脉血流速度均显著高于气压仪组;联合组DVT发生率显著低于气压仪组,发生时间长于气压仪组;联合组皮肤发红、皮癣、皮痒、压疮等皮肤并发症发生率显著低于气压仪组,差异均有统计学意义(均P<0.05)。结论:间歇性气压治疗联合个性化护理应用于ICU患者,可有效预防DVT的形成,值得应用推广。Objective:To observe the clinical application effect of intermittent pneumatic therapy combined with personalized nursing to prevent the formation of deep venous thrombosis(DVT)in ICU patients.Methods:Eighty-two patients in ICU of our hospital from February 2019 to February 2020 were randomly divided into combination group(n=41)and barometer group(n=41).Patients in the barometer group were intervened with intermittent barometer on the basis of routine nursing,while patients in the combined group were given personalized nursing on the basis of barometer group.Both groups were intervened continuously for 21 days.The high shear level of whole blood viscosity,low shear level of whole blood viscosity,D-dimer level,prothrombin time(PT),partial activated prothrombin time(APTT),blood flow velocity of deep femoral vein,popliteal vein and posterior tibial vein were compared between the two groups after 21 days of intervention.Results:The high shear level of whole blood viscosity,low shear level of whole blood viscosity and D-dimer level in the combined group were significantly lower than those in the barometer group.Pt and APTT in the two groups were shorter than before intervention,and the shortening degree of the combined group was significantly greater than that of the barometer group.The blood flow velocity of deep femoral vein,popliteal vein and posterior tibial vein in the combination group was significantly higher than that in the barometer group.The incidence of DVT in the combined group was significantly lower than that in the barometer group,and the occurrence time was longer.In the barometer group,the incidence of skin complications such as skin redness,tinea,pruritus and pressure sore in the combined group was significantly lower than that in the barometer group,the differences were statistically significant(P<0.05).Conclusion:Intermittent pneumatic therapy combined with personalized nursing can effectively prevent the formation of DVT,which is worthy of promotion.

关 键 词：下肢静脉血栓 间歇性气压治疗 个性化护理 

分 类 号：R54[医药卫生—心血管疾病]