康复训练对关节置换术后下肢深静脉血栓的预防作用

The preventative effects of rehabilitation training on deep venous thrombosis after arthroplasty

目的探讨康复训练预防髋、膝关节置换术后下肢深静脉血栓(DVT)的疗效和安全性。方法选择56例接受髋、膝关节置换术的患者,随机分成预防组和对照组,预防组术后进行足踝主动运动、股四头肌等长收缩运动和深呼吸训练,对照组术后嘱患者家属按摩患者患侧小腿。术前和术后第7天分别行彩色多普勒超声检查,检测股静脉血流速度及观察下肢DVT的发生情况。结果康复训练后,预防组股静脉血流峰速度和平均速度均高于对照组,差异有统计学意义(P＜0．01)；预防组有1例患者(3．57%)发生DVT,对照组有6例患者(21．43%)发生DVT,2组比较差异有统计学意义(P＜0．05)。结论足踝主动运动、股四头肌等长收缩运动结合深呼吸训练可提高下肢静脉血流速度,安全、有效地预防髋、膝关节置换术后下肢DVT的形成。

Objective To evaluate the preventative effects of rehabilitation training （RT） on deep venous thrombosis （DVT） after arthroplasty. Methods Fifty-six patients with articulatio coxae or knee arthroplasty were randomly divided into a control group and an experiment group （E group）. RT, including active movement of the foot and ankle, isometric contraction of the quadriceps fexoris and deep breathing training, was administered to the E group after arthroplasty. Negative cheirapsis was applied in the control group. Peak and average blood flow velocities （PABFVs） in the femoral vein, as well as DVT, were detected and measured using color ultrasound Doppler imaging before and 7 d after arthroplasty. Results PABFVs in the E group were higher than those in the control group （P〈0.01）. Six of 28 patients in the control group （21.43%） and 1 of 28 patients in the E group （3.57%） developed DVT, a difference significant at the P 〈 0.05 level. Conclusion RT is safe and effective for preventing DVT in patients with articulatio coxae or knee arthroplasty.