气压治疗对脊髓损伤患者下肢深静脉血栓形成的预防作用研究  

Study on the preventive effect of pneumatic compression therapy on deep venous thrombosis of lower limbs in patients with spinal cord injury

作　　者：张金龙 倪朝民 黄炎 吴鸣 陶冶 周静[1] 汪澄 ZHANG Jinlong;NI Chaomin;HUANG Yan;WU Ming;TAO Ye;ZHOU Jing;WANG Cheng(Rehabilitation Department,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei,Anhui 230001,P.R.China;Rehabilitation Department,Hefei BOE Hospital,BOE Technology Group Co.,Ltd,Hefei,Anhui 230012,P.R.China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)康复医学科,合肥230001 [2]京东方科技集团股份有限公司合肥京东方医院康复医学科,合肥230012

出　　处：《华西医学》2021年第11期1550-1555,共6页West China Medical Journal

基　　金：安徽省重点研究与开发计划项目(202004h07020017)。

摘　　要：目的了解气压治疗对脊髓损伤患者下肢深静脉血栓形成(deep vein thrombosis,DVT)的预防作用。方法回顾性纳入出院时间在2017年4月-2020年12月的在中国科学技术大学附属第一医院由骨科转入康复医学科行康复治疗的脊髓损伤患者,根据病例资料的医嘱内容分为治疗组和对照组,治疗组干预方法为气压治疗+常规康复治疗,对照组为常规康复治疗。采用多因素logistic回归探讨气压治疗与患者DVT发生风险的关系。结果最终纳入153例患者,其中治疗组71例,对照组82例。康复治疗结束后治疗组有10例(14.1%)发生DVT,对照组有21例(25.6%)发生DVT,两组间DVT发生率差异无统计学意义(χ^(2)=3.129,P=0.077)。随访半年后显示,治疗组有11例(15.5%)发生DVT,对照组有12例(14.6%)发生DVT,两组间DVT发生率差异无统计学意义(χ^(2)=0.022,P=0.882)。D-二聚体[比值比(odds ratio,OR)=1.104,95%置信区间(confidence interval,CI)(1.036,1.175),P=0.002]和年龄[OR=1.081,95%CI(1.040,1.124),P<0.001]是治疗后DVT发生风险的独立危险因素。气压治疗[OR=0.210,95%CI(0.075,0.591),P=0.003)]是治疗后DVT发生风险的保护因素。年龄[OR=1.057,95%CI(1.008,1.108),P=0.023]是半年后DVT发生风险的独立危险因素,但气压治疗的作用无统计学意义(P=0.393)。结论脊髓损伤后,需加强对血液高D-二聚体状态的管理,尤其需要关注高龄患者DVT风险,气压治疗可以作为降低住院期间脊髓损伤患者DVT发生风险的治疗措施,但半年后的预防作用有待进一步研究。Objective To understand the preventive effect of pneumatic compression therapy on deep vein thrombosis(DVT) in lower limbs of patients with spinal cord injury. Methods Patients with spinal cord injury who transferred from Orthopedics Department to Rehabilitation Department undergoing rehabilitation in the First Affiliated Hospital of University of Science and Technology of China and discharged from April 2017 to December 2020 were retrospectively included. According to the contents of the medical order of the case data, the patients were divided into treatment group and control group. The intervention method of the treatment group was pneumatic compression therapy and conventional rehabilitation treatment, and the control group was conventional rehabilitation treatment. Multivariate logistic regression was used for statistical analysis to explore the association of pneumatic compression therapy and the risk of DVT in patients with spinal cord injury. Results Finally, 153 patients were enrolled, including 71 cases in the treatment group and 82 cases in the control group. After rehabilitation therapy, DVT occurred in 10 cases(14.1%) in the treatment group and 21 cases(25.6%) in the control group. There was no significant difference in incidence of DVT between the two groups(χ^(2)=3.129, P=0.077). After six months of follow-up, DVT occurred in 11 cases(15.5%) in the treatment group and 12 cases(14.6%) in the control group. There was no significant difference in incidence of DVT between the two groups(χ^(2)=0.022, P=0.822). D-dimer [odds ratio(OR) =1.104, 95% confidence interval(CI)(1.036,1.175), P=0.002] and age [OR=1.081, 95%CI(1.040, 1.124), P<0.001] were independent risk factors for the risk of DVT after treatment. Pneumatic compression therapy was a protective factor for the risk of DVT [OR=0.210, 95%CI(0.075,0.591), P=0.003]. Age [OR=1.057, 95%CI(1.008, 1.108), P=0.023] was an independent risk factor for the risk of DVT after six months. The effect of pneumatic compression therapy was not statistically signif

关 键 词：脊髓损伤 深静脉血栓形成 气压治疗 

分 类 号：R651.2[医药卫生—外科学] R543.6[医药卫生—临床医学]