间歇性充气加压装置对老年危重症患者下肢DVT的预防作用  

Preventive effect of intermittent pneumatic compression device on lower extremity DVT in elderly critically ill patients

作　　者：杜蕾[1] 汪洋[2] Du Lei;Wang Yang(Department of Gerontology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院老年医学科,上海200092 [2]上海交通大学医学院附属新华医院普外科,上海200092

出　　处：《血管与腔内血管外科杂志》2021年第4期408-412,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨间歇性充气加压(IPC)装置对老年危重症外周导入中心静脉导管(PICC)置管患者下肢深静脉血栓形成(DVT)的预防作用及对血流动力学的影响。方法收集2016年1月至2020年12月上海交通大学医学院附属新华医院收治的老年危重症PICC置管患者的临床资料。比较两组患者DVT的发生情况,治疗前后的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)],双下肢股静脉、腘静脉平均血流速度,以及不良反应发生情况。结果观察组患者DVT的发生率为3.57%(2/56),低于对照组患者的16.07%(9/56),差异有统计学意义(P<0.05)。治疗后,观察组患者的PT、APTT、TT均长于对照组患者,FDP、D-D水平均低于对照组患者,差异均有统计学意义(P<0.05)。治疗后,观察组患者双下肢股静脉、腘静脉的平均血流速度均快于对照组患者,差异均有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论间歇性充气加压治疗能够降低老年危重症静脉PICC置管患者下肢DVT的发生风险,改善患者血流动力学和凝血状态。Objective To investigate the preventive effect and hemodynamic effect of intermittent pneumatic compression(IPC)device on lower extremity deep venous thrombosis(DVT)in elderly critically ill patients with venous peripherally inserted central venous catheter(PICC)catheterization.Method The clinical data of 112 elderly critically ill patients with venous PICC catheterization in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2020 were collected.According to the different treatment methods,the patients were divided into observation group(using conventional lower extremity DVT preventive treatment and IPC treatment)and control group(using conventional lower extremity DVT preventive treatment),56 cases in each group.The incidence of DVT in the two groups was compared.The coagulation function indexes[prothrombin time(PT),activited partial thomboplastin time(APTT),thrombin time(TT),fibrin degradation product(FDP),D-dimer(D-D)]of the two groups before and after treatment were observed,and the average blood flow velocity of each vein of lower limbs.The average blood flow velocity of femoral vein and popliteal vein of both lower limbs,and incidence of adverse reactions were compared between the two groups.Result The incidence rate of DVT in the observation group was 3.57%(2/56),which was lower than that in the control group[16.07%(9/56)],and the difference was statistically significant(P<0.05).After treatment,PT,APTT and TT in the two groups were longer than before treatment,level of FDP and D-D were lower than before treatment,the differences were statistically significant(P<0.05).PT,APTT and TT in the observation group were faster than those in the control group,level of FDP and D-D were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the average blood flow velocity of femoral vein and popliteal vein in both lower limbs in the observation group was faster than that in the control group,with statistica

关 键 词：危重症 老年 间歇性充气加压 深静脉血栓形成 外周导入中心静脉导管 血流动力学 

分 类 号：R543[医药卫生—心血管疾病]