早期干预对慢性阻塞性肺疾病急性加重期患者并发下肢深静脉血栓的预防价值  

Preventive value of early intervention for lower extremity deep vein thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：秦岚[1] 李莎莎[2] 张燕 Qin Lan;Li Shasha;Zhang Yan(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 101125,China;Department of Intervention,Fourth Medical Center of Chinese PLA General Hospital,Beijing 100089,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京101125 [2]解放军总医院第四医学中心介入科,北京100089

出　　处：《血管与腔内血管外科杂志》2025年第1期26-30,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的 探讨早期干预对慢性阻塞性肺疾病急性加重期(AECOPD)患者并发下肢深静脉血栓的预防价值。方法 收集2020年5月至2023年5月首都医科大学附属北京友谊医院收治的166例AECOPD患者的临床资料,根据入院后预防下肢DVT的时间将患者分为早期组(n=75,入院12 h内开始进行下肢DVT的预防)和对照组(n=91,入院24h后开始进行下肢DVT的预防)。比较两组患者住院期间的治疗情况和结局指标,并以住院期间下肢DVT的发生率作为主要观察指标,住院期间并发症的发生率、凝血酶原时间、活化部分凝血活酶时间以及出院之前复查的D-二聚体水平为次要观察指标。结果 住院期间,两组患者使用呼吸机、使用低分子肝素、穿弹力袜、采用间歇性气压治疗的比例比较,差异均无统计学意义(P>0.05);早期组的启动干预时间早于对照组患者,下肢DVT的发生率低于对照组患者,差异均有统计学意义(P<0.05);两组患者凝血酶原时间、活化部分凝血活酶时间及并发症的发生率比较,差异均无统计学意义(P>0.05)。出院之前复查结果显示,早期组D-二聚体水平升高的患者比例低于对照组,差异有统计学意义(P<0.05)。结论 早期干预可以降低AECOPD患者发生下肢DVT的风险,具有较高的安全性,值得临床推广与进一步研究。Objective To investigate the preventive value of early intervention for lower extremity deep vein thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method The clinical data of 166 AECOPD patients admitted to Beijing Friendship Hospital,Capital Medical University from May 2020 to May 2023 were collected.The patients were divided into early group(n=75,prevention of lower extremity DVT started within 12 h of admission)and control group(n=91,prevention of lower extremity DVT started 24 h after admission)based on the time taken to prevent lower extremity DVT after admission.The treatment status and outcome indicators of two groups of patients during hospitalization were compared,and the incidence of lower extremity DVT during hospitalization was taken as the main observation indicator,while the incidence of complications,prothrombin time,activated partial thromboplastin time during hospitalization,and D-dimer levels rechecked before discharge was taken as secondary observation indicators.Result During hospitalization,there were no statistically significant differences in the proportion of patients using ventilators,low molecular weight heparin,elastic stockings,and intermittent pneumatic therapy between the two groups of patients(P>0.05);the early group patients started earlier than the control group patients,and the incidence of lower extremity DVT was lower than that of the control group patients,and the differences were statistically significant(P<0.05);there were no statistically significant differences in prothrombin time,activated partial thromboplastin time,and incidence of complications between the two groups of patients(P>0.05).The re-examination results showed that the proportion of patients with elevated D-dimer levels in the early group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Early intervention can significantly reduce the risk of lower extremity DVT in AECOPD patients,with high safety,and is

关 键 词：慢性阻塞性肺疾病急性加重期 下肢 深静脉血栓 预防 

分 类 号：R543[医药卫生—心血管疾病]