间歇充气加压装置对预防癫痫持续状态患者下肢深静脉血栓形成的效果研究  

Study on the effect of intermittent pneumatic compression device on preventing deep venous thrombosis of lower extremity in patients with epileptic status

作　　者：张未迟 刘芳[1] 王晓英[1] 陈卫碧[1] Zhang Weichi;Liu Fang;Wang Xiaoying;Chen Weibi(Department of Neurological Intensive Care Unit,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科监护室,北京100053

出　　处：《中国实用护理杂志》2023年第32期2487-2493,共7页Chinese Journal of Practical Nursing

摘　　要：目的探讨采用不同间歇充气加压装置(IPC)使用方案对预防癫痫持续状态(SE)患者下肢深静脉血栓形成(DVT)的效果研究,为SE患者入院后早期合理应用IPC提供护理依据。方法采用类实验研究方法,便利抽样选取2018年1月至2022年5月首都医科大学宣武医院神经内科监护室SE患者76例为研究对象。将2018年1月至2020年2月住院的35例患者设为对照组,将2020年3月至2022年5月住院的41例患者设为干预组。2组患者入院后均给予抗癫痫药物(ASMs)积极止痫,对照组患者IPC应用频次及时长为2次/d,每次1 h;干预组患者IPC应用频次及时长为1次/d,每次≥12 h。比较2组SE患者下肢DVT发生、癫痫临床发作、脑电图异常放电及与下肢DVT形成相关的凝血指标情况。结果入院时2组SE患者纤维蛋白原、D-二聚体、凝血酶时间比较差异均无统计学意义(均P>0.05)。出院时干预组纤维蛋白原、D-二聚体、凝血酶时间分别为(4.02±1.71)g/L、7.06(5.33,15.01)mg/L、10.22(7.53,14.42)s,低于对照组的(4.98±1.62)g/L、11.92(5.75,15.26)mg/L、17.96(13.21,28.14)s,2组比较差异均有统计学意义(t=3.03,Z=4.32、1.56,均P<0.05)。对照组患者下肢DVT发生率为62.86%(22/35),干预组为12.20%(5/41),2组比较差异有统计学意义(χ^(2)=21.59,P<0.01)。结论SE患者在给予ASMs使用临床发作得到有效控制的基础上,早期使用IPC且每日治疗时间≥12 h,可避免诱发癫痫发作,降低下肢DVT的形成及发生风险,改善血液高凝状态。Objective To investigate the preventive effect of different intermittent pneumatic compressiondevices(IPC)schemes on deep vein thrombosis(DVT)of lower extremity in patients with status epilepticus(SE),to provide nursing basis for rational application of IPC in early admission of SE patients.Methods A similar experimental study was conducted and 76 SE patients in the intensive care unit of the Department of Neurology,Xuanwu Hospital,Capital Medical University from January 2018 to May 2022 were selected by convenience sampling method.The 35 SE patients hospitalized from January 2018 to February 2020 were included in the control group,and 41 patients hospitalized from March 2020 to May 2022 were included in the intervention group.Both groups were given anti-seizure medications(ASMs)to actively control seizures after admission.IPC application frequency and duration in control group were twice a day,1 hour each time;the frequency of IPC application in the intervention group was once a day for greater than or equal to 12 hours each time.The incidence of lower limb DVT,epileptic seizure,abnormal electroencephalogram discharge and coagulation index related to lower limb DVT formation were compared between the two groups.Results There was no significant difference in the indexes of fibrinogen,D-dimer and thrombin time between the two groups of SE patients at admission(P>0.05).At discharge,the indexes of fibrinogen,D-dimer and thrombin time were(4.02±1.71)g/L,7.06(5.33,15.01)mg/L and 10.22(7.53,14.42)s in the intervention group respectively,which were lower than(4.98±1.62)g/L,11.92(5.75,15.26)mg/L and 17.96(13.21,28.14)s in the control group,the differences were statistically significant(t=3.03,Z=4.32,1.56,all P<0.05).The DVT incidence rate was 62.86%(22/35)in the control group,and the intervention group was 12.20%(5/41).The difference was statistically significant(χ^(2)=21.59,P<0.01).Conclusions On the basis of effective control of clinical seizures in SE patients treated with ASMs,early IPC use and daily treatment tim

关 键 词：癫痫持续状态 深静脉血栓形成 重症监护病房 间歇充气加压装置 

分 类 号：R473.74[医药卫生—护理学]