骨科创伤手术患者治疗中防治下肢深静脉血栓形成的有效方法及措施  

Effective methods and measures for preventing and treating deep vein thrombosis in orthopedic trauma surgery patients

作　　者：马骥 许国强 高化[1] 白晓冬[1] 刘振宇[1] 王刚[1] 陈文韬[1] 王宝军[1] MA Ji;XU Guoqiang;GAO Hua;BAI Xiaodong;LIU Zhenyu;WANG Gang;CHEN Wentao;WANG Baojun(Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《中国骨与关节损伤杂志》2024年第5期492-495,共4页Chinese Journal of Bone and Joint Injury

基　　金：北京市属医院科研培育计划(PX2021004)。

摘　　要：目的研究骨科创伤手术患者防治下肢深静脉血栓形成(Deep venous thrombosis,DVT)的有效方法与措施。方法收集自2021-03—2023-05于笔者所在医院就诊的184例骨科创伤手术作为研究对象。所有患者入院后由经过培训的医师协助完成Caprini血栓风险评估量表,选取危险因素总分2分(中危组)的患者,随机分成研究组86例与对照组98例。对照组根据指南仅使用药物进行单一治疗,研究组除药物治疗外还采用物理措施,血栓发生后下腔静脉滤器置入以及术前护理、康复、运动干预。结果两组均获得随访,随访时间6~12个月,平均9.7个月。研究组中11例DVT(12.79%),对照组中23例DVT(23.47%);研究组DVT的发生情况优于对照组,差异有统计学意义(χ^(2)=3.467,P=0.046)。所有DVT患者均进行对症治疗,研究组治疗有效率为90.90%;对照组治疗有效率为82.60%。研究组不良反应发生率为11.63%;对照组不良反应发生率为23.47%;研究组不良反应发生率低于对照组,差异有统计学意义(χ^(2)=3.411,P=0.049)。结论对骨科创伤手术患者采用有效预防措施和综合治疗手段可以降低DVT发生率、不良反应发生率,减轻患者病情严重程度,有利于尽快康复。Objective To explore effective methods and measures for preventing and treating deep vein thrombosis(DVT)in patients with orthopedic trauma surgery.Methods All 184 patients undergoing orthopedic trauma surgery at the hospital from March 2021 to May 2023 were selected as the study subjects.After admission,all patients were assisted by trained physicians to complete the Caprini thrombosis risk assessment scale.Patients with a total score of 2 points(moderate-risk group)were randomly divided into a study group of 86 cases and a control group of 98 cases.The control group received only drug therapy according to guidelines,while the study group received physical measures in addition to drug therapy,including placement of inferior vena cava filters after thrombosis occurrence,preoperative care,rehabilitation,and exercise intervention.Results Both groups were followed up for 6 to 12 months,with an average of 9.7 months.In the study group,there were 11 cases of DVT(12.79%),while in the control group,there were 23 cases of DVT(23.47%).The occurrence of DVT in the study group was superior to that in the control group,with statistically significant differences(χ^(2)=3.467,P=0.046).All DVT patients received symptomatic treatment,with an effective treatment rate of 90.90%in the study group and 82.60%in the control group.The incidence of adverse reactions in the study group was 11.63%,while in the control group,it was 23.47%.The incidence of adverse reactions in the study group was lower than that in the control group,with statistically significant differences(χ^(2)=3.411,P=0.049).Conclusion Implementing effective preventive measures and comprehensive treatment methods for orthopedic trauma surgery patients can reduce the incidence of DVT and the occurrence of adverse reactions,alleviate the severity of patients'conditions,and facilitate their speedy recovery.

关 键 词：下肢深静脉血栓形成 骨科创伤手术 下腔静脉滤器 预防 

分 类 号：R619[医药卫生—外科学]