踝泵训练联合低分子肝素钙治疗脑卒中偏瘫合并下肢深静脉血栓有效性及安全性  

Effectiveness and safety of ankle pump training combined with low molecular heparin calcium in the treatment of stroke hemiplegia combined with lower extremity deep vein thrombosis

作　　者：李叶子 余平[1] LI Yezi;YU Ping(The Third Hospital of Wuhan/Affiliated Tongren Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]武汉市第三医院/武汉大学附属同仁医院,湖北武汉430000

出　　处：《中国实用神经疾病杂志》2024年第5期616-621,共6页Chinese Journal of Practical Nervous Diseases

基　　金：武汉市医学科研项目(编号:WX19D22)。

摘　　要：目的 探讨踝泵训练联合低分子肝素钙治疗脑卒中偏瘫合并下肢深静脉血栓有效性及安全性。方法 随机选取2020-07—2022-09于武汉大学附属同仁医院/武汉市第三医院诊治的119例脑卒中偏瘫合并下肢深静脉血栓患者为研究对象,按照随机数字表法分为训练组40例、药物组40例及联合组39例,分别给予踝泵训练干预、低分子肝素钙干预及联合干预。分析患者治疗有效性及安全性。观察血液相关指标、肢体功能、日常生活能力变化。结果 联合组治疗有效率(92.31%)明显高于训练组(75.00%)及药物组(70.00%,P<0.05)。干预后,3组患者血液相关指标均明显降低(P<0.05),且联合组纤维蛋白原(FIB)、D-二聚体(D-D)、血浆黏度及全血黏度低于训练组与药物组(P<0.05),凝血酶原时间(PT)水平高于训练组与药物组(P<0.05)。干预后3组患者患者肢体功能均明显升高(P<0.05),联合组各指标高于训练组与药物组(P<0.05)。干预后3组患者患者ADL评分及BI评分均明显升高(P<0.05),联合组各指标高于训练组与药物组(P<0.05)。联合组不良反应发生率(2.56%)明显低于训练组(22.50%)及药物组(22.50%,P<0.05)。训练组与药物组各指标均无统计学差异(P>0.05)。结论 踝泵训练联合低分子钙素钙在脑卒中偏瘫合并下肢深静脉血栓患者的治疗中具有较高的有效性,能够显著减轻血液粘稠度,改善凝血功能与肢体运动功能,有利于提高患者的生活质量,且安全性较高。Objective To investigate the effectiveness and safety of ankle pump training combined with low molecular heparin calcium in the treatment of stroke hemiplegia combined with lower limb deep vein thrombosis.Methods Totally 119 patients with stroke hemiplegia combined with lower limb deep vein thrombosis who were treated in the Affiliated Tongren Hospital of Wuhan University/Wuhan Third Hospital from July 2020 to September 2022 were randomly selected as the study object,and they were divided into the training group of 40 cases and the medication group of 40 cases,and the combined group of 39 cases according to the method of randomized numerical table.Ankle pump training intervention,low molecular weight heparin calcium intervention and combined intervention were given respectively.The efficacy and safety of treatment were analyzed.Blood related indexes,limb function and daily living ability were observed.Results The treatment efficiency of the combined group(92.31%)was significantly higher than that of the training group(75.00%)and the drug group(70.00%,P<0.05).After the intervention,the blood-related indexes of the three groups were significantly decreased(P<0.05),and the fibrinogen(FIB),D-dimer(D-D),plasma viscosity and whole blood viscosity of the combined group were lower than those of the training and drug groups(P<0.05),and the prothrombin time(PT)level was higher than that of the training and drug groups(P<0.05).After intervention,the limb function of the three groups was significantly increased(P<0.05),and the indexes of the combined group were higher than those of the training group and the drug group(P<0.05).After intervention,the ADL score and BI score of the 3 groups were significantly increased(P<0.05),and the indexes of the combined group were higher than those of the training group and the drug group(P<0.05).The incidence of adverse reactions in combination group(2.56%)was significantly lower than that in training group(22.50%)and drug group(22.50%,P<0.05).There was no significant difference between t

关 键 词：踝泵训练 低分子肝素钙 脑卒中 偏瘫 下肢深静脉血栓 肢体运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]