中国全科医学2017，Vol.20Issue(3)：318-322,330,6.DOI:10.3969/j.issn.1007-9572.2017.03.011
多种方法预防ICU长期住院患者下肢深静脉血栓形成的效果评价
Effects of Multiple Methods on Preventing Deep Vein Thrombosis of Long-term Hospitalized Patients in ICU
摘要
Abstract
Objective To compare the effects of drugs ( low molecular weight heparin sodium ), air pressure intervention and physical exercise combined with acupuncture point massage on preventing deep vein thrombosis( DVT)of long―term hospitalized patients in ICU. Methods According to the inclusion standard,ninety long―term hospitalized patients in ICU of the Second Affiliated Hospital of Wenzhou Medical University from June 2014 to October 2015 were selected. The subjects were randomly divided into the following three groups:heparin group,air pressure intervention group,and exercise combined with massage group. Each group had 30 patients. The heparin group received low molecular weight heparin sodium injection. The air pressure intervention group received air pressure intervention of lower limbs,and exercise combined with massage group received physical exercise combined with acupuncture point massage. The intervention of the three groups lasted for 21 days. The level of high cut and low cut of whole blood viscosity,D ― dimer,prothrombin time( PT),activated partial thromboplastin time ( APTT),and blood flow velocity of deep femoral vein,popliteal vein and posterior tibial vein at the first,seventh and twenty―first day of the treatment among patients in the three groups were compared,and the incidence of DVT of patients intervened at the first,seventh and twenty―first day was summarized. Results The intervention method and time had significant interactive effects on the high cut and low cut of whole blood viscosity(p〈0. 05);the intervention method and time had significantly main effect on the high cut and low cut of whole blood viscosity(p〈0. 05);the high cut and low cut of whole blood viscosity at the twenty―first day of intervention were lower than those at the first day of intervention among patients in the three groups ( p〈0. 05 );the high cut and low cut of whole blood viscosity at the twenty―first day of intervention in air pressure intervention group and exercise combined with massage group were higher than those in heparin group ( p〈0. 05 ). The intervention method and time had significant interactive effects and significantly main effect on the D―dimer level(p〈0. 05);there was no significant difference in the D―dimer level at the first,seventh and twenty―first day of intervention among the three groups(p〉0. 05). The intervention method and time had significant interactive effects and significantly main effect on PT and APTT ( p〈0. 05 );the PT and APTT at the twenty―first day of intervention were lower than those at the first day of intervention among patients in the three groups( p 〈0. 05 );the PT and APTT at the twenty ― first day of intervention in air pressure intervention group and exercise combined with massage group were longer than those in heparin group ( p〈0. 05 ). The intervention method and time had significant interactive effects and significantly main effect on blood flow velocity of deep femoral vein,popliteal vein and posterior tibial vein(p 〈0. 05);the blood flow velocity of deep femoral vein,popliteal vein and posterior tibial vein at the twenty―first day of intervention were faster than those at the first day of intervention among patients in the three groups ( p〈0. 05);the blood flow velocity of deep femoral vein, popliteal vein and posterior tibial vein at the twenty ― first day of intervention in air pressure intervention group and exercise combined with massage group were slower than those in heparin group (p〈0. 05). No DVT occurred in the three groups at the first day of the intervention;no DVT occurred in the heparin group at the seventh day of the intervention,and the incidence of DVT in the air pressure intervention group,and exercise combined with massage group was both 3. 3﹪(1/30). At the 21st day of the intervention,the incidence of DVT in heparin group,air pressure intervention group,and exercise combined with massage group was 3. 3﹪(1/30),16. 7﹪(5/30),and 13. 3﹪(4/30)respectively. Conclusion Drugs,air pressure and physical exercise combined with acupuncture point massage have certain effects on the prevention of DVT,and the effect of low molecular weight heparin is the best.关键词
静脉血栓形成/下肢/肝素,低分子量/重症监护病房Key words
Venous thrombosis/Lower extremity/Heparin,low-molecular-weight/Intensive care units分类
医药卫生引用本文复制引用
陈玉桃,吕畅,陈少敏,林孟相..多种方法预防ICU长期住院患者下肢深静脉血栓形成的效果评价[J].中国全科医学,2017,20(3):318-322,330,6.基金项目
温州市科技局计划项目 （）
