间歇充气加压预防慢阻肺患者下肢深静脉血栓的Meta分析  

A meta-analysis of the efficacy of intermittent pneumatic compression in the prevention of lower deep vein thrombosis in patients with chronic obstructive pulmonary disease

作　　者：李玉芊 曾雯姝 鲁兰莫 保燕[2] LI Yuqian;ZENG Wenshu;LU Lanmo;BAO Yan(School of Nursing,Yunnan University of Chinese Medicine,Kunming 650500;Affiliated Hospital of Yunnan University,Kunming 650021,China)

机构地区：[1]云南中医药大学护理学院,650500 [2]云南大学附属医院,650021

出　　处：《中国老年保健医学》2024年第5期27-32,共6页Chinese Journal of Geriatric Care

摘　　要：目的评价间歇充气加压(intermittent pneumatic compression,IPC)预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者下肢深静脉血栓形成的有效性。方法检索维普数据库(VIP)、中国知网学术文献总库(CNKI)、万方数据库(Wanfang Datebase)、PubMed、Embase、The Cochrane Library等中英文数据库,收集关于间歇充气加压预防慢性阻塞性肺疾病患者下肢深静脉血栓形成的随机对照试验(RCTs),检索时限均为建库到2024年3月。由2名研究人员独立根据纳入和排除标准、Cochrane风险评估工具对纳入的研究进行筛选,并进行数据提取和质量评价。运用RevMan 5.4软件对纳入文献进行Meta分析。结果最终纳入5篇文献,包括541例患者。Meta分析结果显示:间歇充气加压组(RR=0.30,95%CI 0.16~0.55,P=0.0001)、间歇充气加压联合抗凝药物组(RR=0.31,95%CI 0.11~0.92,P=0.04)的深静脉血栓形成的发生率分别低于常规组、抗凝药物组,差异均有统计学意义(P<0.05)。间歇充气加压组的机械通气时间(SMD=-1.94,95%CI-4.38~-0.49,P=0.12)和重症监护室(intensive care unit,ICU)住院时间(SMD=-0.17,95%CI-0.38~-0.05,P=0.13)均短于常规组,但差异均无统计学意义(P>0.05)。结论间歇充气加压装置可以有效降低慢性阻塞性肺疾病患者下肢深静脉血栓形成的发生率,且与抗凝药物联用较单独使用更有效。Objective To evaluate the effectiveness of intermittent pneumatic compression(IPC)in the prevention of lower deep vein thrombosis(DVT)in patients with chronic obstructive pulmonary disease(COPD).Methods Randomized controlled trials(RCTs)on the application of IPC in patients with COPD in VIP database,China Knowledge Network and Wanfang Database,PubMed,Embase,The Cochrane Library were searched by computer for the period from their establishment to March 2024.Included studies were screened independently by 2 researchers according to inclusion and exclusion criteria,Cochrane Risk Assessment Tool,and data extraction and quality assessment were performed.Meta-analysis of the included literature was performed using RevMan 5.4 software.Results Five papers,including 541 patients,were finally included.Meta analysis showed that the incidence of DVT in IPC group(RR=0.30,95%CI 0.16~0.55,P=0.0001),IPC combined with anticoagulant drugs group(RR=0.31,95%CI 0.11~0.92,P=0.04)was lower than the conventional group and anticoagulant drug group,and the differences were all statistically significant(P<0.05).The duration of mechanical ventilation(SMD=-1.94,95%CI-4.38~-0.49,P=0.12)and the stay time in ICU(SMD=-0.17,95%CI-0.38~-0.05,P=0.13)in IPC group was shorter than that in the conventional group,and the differences were not statistically significant(P>0.05).Conclusion IPC can reduce the incidence of DVT in patients with COPD,and the prevention effect of DVT in combination with anticoagulant drug is better than single prevention method.

关 键 词：间歇充气加压 慢性阻塞性肺疾病 深静脉血栓 预防 

分 类 号：R563.9[医药卫生—呼吸系统]