全髋关节置换患者间歇性充气加压装置单次最佳使用时长的临床试验研究  

Clinical trial of optimal single use duration of intermittent pneumatic compression device in patients with total hip replacement

作　　者：周琪 窦晨浩 丁俊琴[3] 张秀果[4] 李宝丽[4] 耿倩[4] 何丽英[5] ZHOU Qi;DOU Chenhao;DING Junqin;ZHANG Xiuguo;LI Baoli;GENG Qian;HE Liying(Department of SpineⅡ,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Department of SpineⅣ,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Information Center,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Department of Nursing,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Department of Osteopathy,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第三医院脊柱二科,河北石家庄050000 [2]河北医科大学第三医院脊柱四科,河北石家庄050000 [3]河北医科大学第三医院信息中心,河北石家庄050000 [4]河北医科大学第三医院护理部,河北石家庄050000 [5]河北医科大学第三医院骨病科,河北石家庄050000

出　　处：《护士进修杂志》2024年第17期1807-1811,1819,共6页Journal of Nurses Training

基　　金：河北省卫生健康委员会医学科学研究课题(编号:20210052)。

摘　　要：目的探讨全髋关节置换术(total hip arthroplasty,THA)患者间歇性充气加压装置(intermittent pneumatic compression,IPC)单次最佳使用时长。方法便利抽取2021年11月-2022年6月在我院行全髋关节置换的患者120例,术后24~48 h内无时间上限地让患者持续接受IPC治疗,直到患者因任意原因要求停止。在开始前静息状态(基线)、每隔30 min、结束时测量患者术侧股总静脉峰值流速(peak velocity,PV)和心理接受度1次;基线、每隔1 h、结束时观察伤口渗血量各1次。对时长和血峰值流速进行相关性分析。结果120例患者IPC平均耐受时长为(80.42±3.31)min,87.5%的患者可耐受60 min,96例(71.1%)患者因影响翻身和其他活动是患者要求停止;IPC任意时长时的PV与静息的PV相比,差异有统计学意义(P均<0.05);耐受IPC 30 min与60 min、90 min、120 min、150 min、180 min时PV相比,差异有统计学意义(P均<0.001);耐受IPC 60 min与90 min、120 min、150 min、180 min时PV相比,差异有统计学意义(P<0.001、P<0.001、P=0.003、P=0.031);其他各耐受时长间PV差异无统计学意义(P>0.05)。IPC不同使用IPC同时一定要做踝泵运动,使用时长均未额外增加伤口渗血。结论对于意识清醒患者,兼顾考虑患者耐受性和对静脉血液流速的促进作用,建议单次使用IPC的时长为60~90 min,可增加每日的使用的频次或使用间歇期间进行踝泵运动。对于意识障碍患者可考虑指南中建议的每天18 h的时长。Objective To explore the best single use duration of intermittent pneumatic compression(IPC)in patients with total hip arthroplasty(THA)based on the patient tolerance.Methods A total of 120 patients who underwent total hip arthroplasty in our hospital from November 2021 to June 2022 was collected by convenient sampling,and were allowed to continue to receive IPC treatment within 24-48 hours after the operation without time limit until the patients requested to stop for any reason.The peak velocity(PV)and psychological acceptance of the patients'common femoral vein blood were measured 1 time at rest before the start(baseline),every 30 minutes,and at the end of the operation;Observe the bleeding volume of the wound were measured each one at rest before the start(baseline),every 1 hour,and at the end.The correlation between time length and peak blood flow rate was analyzed.ResuIts The average duration of IPC tolerance in 120 patients was(80.42±3.31)min,87.5%of patients could tolerate 60 min,and 96 patients(71.1%)asked to stop because of the influence of turning and other activities;Compared with the PV at rest,the PVs at any time of IPC were statistically significant(all P<0.05);Compared with PV at 60 min,90 min,120 min,150 min,and 180 min,there were statistically significant differences(all P<0.001);Compared with PV at 90 min,120 min,150 min,and 180 min,there were statistically significant differences(P<0.001,P<0.001,P=0.003,P=0.031);There was no significant difference in PV between other tolerance durations(P>0.05).IPC did not increase wound blood leakage for different use periods.Conclusion For conscious patients,taking into account patient tolerance and the promotion of venous blood flow rate,it is recommended to use IPC for a single time of 60min to 90min,which can increase the frequency of daily use or use ankle pump exercise during intermittent use.The recommended 18 hours per day in the guidelines may be considered for people with disturbance of consciousness.

关 键 词：全髋关节置换 间歇性充气加压装置 使用时长 股总静脉峰值血流 

分 类 号：R472[医药卫生—护理学]