下肢气压泵于ICU长期机械通气患者下肢DVT防治中的应用效果  

Application effect of lower extremity pneumatic pump on prevention and treatment of lower limb DVT in ICU patients with long-term mechanical ventilation

作　　者：鲍金凤 乔莉[1] 庄艳[1] 孙存芹 邓建武[2] Bao Jinfeng;Qiao Li;Zhuang Yan;Sun Cunqin;Deng Jianwu(Department of Intensive Care Unit,Lianyungang Second People's Hospital,Lianyungang 222022,Jiangsu,China;Department of Vascular Surgery,Lianyungang Second People's Hospital,Lianyungang 222022,Jiangsu,China)

机构地区：[1]连云港市第二人民医院重症医学科,江苏连云港222022 [2]连云港市第二人民医院血管外科,江苏连云港222022

出　　处：《血管与腔内血管外科杂志》2021年第10期1240-1243,1255,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨下肢气压泵于重症医学科(ICU)长期机械通气患者下肢深静脉血栓形成(DVT)防治中的应用效果。方法收集2019年1月至2021年1月于连云港市第二人民医院ICU需长期机械通气92例患者的临床资料,根据治疗方式的不同将患者分为对照组(采用常规下肢DVT防治)和观察组(在常规防治方案基础上联合应用下肢气压泵治疗),每组46例。治疗1个疗程后,比较两组患者治疗前后下肢股深静脉血流速度指标(平均血流速度,血流峰速度增加值,踝部、小腿周径增加值)、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)水平],以及下肢DVT、疼痛、肿胀、皮肤颜色异常的发生率。结果治疗后,观察组患者的下肢股深静脉平均血流速度、血流峰速度增加值均高于对照组患者,踝部、小腿周径增加值低于对照组患者,差异均有统计学意义(P<0.05)。治疗后,观察组患者的APTT、PT均长于对照组患者,D-D水平低于对照组患者,差异均有统计学意义(P<0.05)。观察组患者下肢DVT、疼痛、肿胀、皮肤颜色异常的发生率均低于对照组患者,差异均有统计学意义(P<0.05)。结论下肢气压泵于ICU长期机械通气患者下肢DVT防治中的应用效果较好,能够改善患者的凝血功能,降低下肢DVT及其相关症状的发生风险,加快静脉血流速度。Objective To investigate the application effect of lower extremity pneumatic pump in the prevention and treatment of lower extremity deep venous thrombosis(DVT)in patients with long-term mechanical ventilation in intensive care unit(ICU).Method The clinical data of 92 patients requiring long-term mechanical ventilation in ICU of Lianyungang Second People's Hospital from January 2019 to January 2021 were collected.According to different treatment methods,the patients were divided into control group(conventional lower limb DVT prevention and treatment)and observation group(combined lower limb pneumatic pump treatment on the basis of conventional prevention and treatment scheme),with 46 cases in each group.After one course of treatment,blood flow velocity of lower extremity deep femoral vein in the two groups before and after treatment was observed(average blood flow velocity,peak blood flow velocity,circumference diameter of ankle and calf)and coagulation function indexes[activated partial thrombin time(APTT),prothrombin time(PT)and D-dimer(D-D)]were analyzed,and the incidence of DVT,pain,swelling and abnormal skin color in lower limbs of patients in the two groups were analyzed.Result After treatment,the average blood flow velocity and increased value of peak blood flow velocity of lower extremity deep femoral vein in the observation group were higher than those in the control group,and the increased value of peripheral diameter of ankle and lower leg were lower than those in the control group,with statistical significance(P<0.05).After treatment,the APTT and PT of patients in the observation group were longer than those in the control group,and the level of D-D was lower than those in the control group,with statistical significance(P<0.05).The incidence rate of lower extremity DVT,pain,swelling and abnormal skin color of lower extremities in the observation group was lower than that in the control group,with statistical significance(P<0.05).Conclusion The application of lower extremity pneumatic pump in the preve

关 键 词：下肢 深静脉血栓形成 机械通气 重症医学科 气压泵 

分 类 号：R543[医药卫生—心血管疾病]