踝泵运动对下肢骨折患者深静脉血栓的预防作用  

Preventive effect of ankle pump exercise on deep vein thrombosis in patients with lower extremity fracture

作　　者：方成成 黄玉凤 童玲[1] 王溢文 Fang Chengcheng;Huang Yufeng;Tong Ling;Wang Yiwen(Second Department of Orthopaedics,the Second People's Hospital of Hefei,Hefei 230000,Anhui,China;Department of Vascular Surgery,the Second People's Hospital of Hefei,Hefei 230000,Anhui,China)

机构地区：[1]合肥市第二人民医院骨二科,安徽合肥230000 [2]合肥市第二人民医院血管外科,安徽合肥230000

出　　处：《血管与腔内血管外科杂志》2023年第5期624-628,共5页Journal of Vascular and Endovascular Surgery

基　　金：合肥市第二人民医院2021年度院级科研项目(2021ygkt53)。

摘　　要：目的探讨踝泵运动对下肢骨折患者术后住院期间下肢深静脉血栓(DVT)的预防作用。方法收集2020年1月至2022年3月于合肥市第二人民医院住院诊治的100例下肢骨折患者的临床资料,根据术后住院期间是否进行踝泵运动将患者分为运动组(n=51)和对照组(n=49)。观察并比较两组患者的手术情况以及术后住院期间下肢DVT的发生情况、急性肺栓塞(APE)的发生情况、D-二聚体情况、大腿周径差、小腿周径差。结果两组患者的骨折部位、骨折至手术所需的时间、手术时间、术中出血量及手术完成至复查D-二聚体的时间比较,差异均无统计学意义(P﹥0.05)。术后住院期间,运动组患者的D-二聚体水平升高比例高于对照组患者,大腿周径差、小腿周径差均小于对照组患者,差异均有统计学意义(P﹤0.05)。运动组患者术后住院期间下肢DVT的发生率为3.9%(2/51),低于对照组患者的18.4%(9/49),差异有统计学意义(P﹤0.05)。两组患者术后住院期间均未发生APE。结论踝泵运动可明显降低下肢骨折患者术后住院期间下肢DVT的发生风险,值得临床根据患者实际情况进行推荐应用。Objective To investigate the preventive effect of ankle pump exercise on lower extremity deep vein thrombosis(DVT)in patient with lower extremity fracture during postoperative hospitalization.Method The clinical data of 100 patients with lower extremity fracture who were hospitalized in the Second People's Hospital of Hefei from January 2020 to March 2022 were collected,patients were divided into exercise group(n=51)and control group(n=49)according to whether ankle pump exercise was taken during postoperative hospitalization.The surgical conditions,incidence of lower extremity DVT,acute pulmonary embolism(APE),D-dimer level,thigh circumference difference and calf circumference difference during postoperative hospitalization were observed and compared.Result There was no significant difference in the fracture site,time from fracture to operation,operation time,intraoperative blood loss and time from operation completion to recheck of D-dimer between the two groups of patients(P>0.05).During postoperative hospitalization,the proportion of elevated D-dimer levels in the exercise group was higher than that in the control group,the thigh circumference difference and calf circumference difference of patients in the exercise group were smaller than those in the control group,and the differences were statistically significant(P<0.05).The results of ultrasonography showed that the incidence rate of lower extremity DVT in the exercise group was 3.9%(2/51),which was lower than 18.4%(9/49)in the control group,and the difference was statistically significant(P<0.05).No APE occurred in the two groups during postoperative hospitalization.Conclusion Ankle pump exercise could significantly reduce the risk of lower extremity DVT during postoperative hospitalization in patient with lower extremity fracture,and it is worthy of clinical recommendation based on the situation of patient.

关 键 词：骨折 下肢 深静脉血栓形成 踝泵运动 急性肺栓塞 预防 

分 类 号：R543[医药卫生—心血管疾病]