关节置换术后间歇充气加压装置治疗时间对深静脉血栓形成的影响

Effect of Duration of Treatment with Intermittent Gradient Pneumatic Compression Device on Deep Vein Thrombosis after Joint Replacement

目的分析关节置换术后间歇充气加压装置(intermittent gradient pneumatic compression device,IPCD)治疗时间对深静脉血栓形成(deep venous thrombosis,DVT)的影响。方法选取2021年6月-2021年12月在本院进行关节置换术治疗患者60例,采用随机数字表法将其平均分为对照组和实验组,每组各30例。两组患者均行关节置换术治疗,术后均给予两组患者IPCD治疗,对照组每日治疗2次,每次治疗时间为1 h;实验组每日治疗2次,每次治疗时间为2 h。对比分析两组患者D-二聚体水平、纤维蛋白原水平、肢体周径以及DVT发生率。结果治疗前,两组患者D-二聚体、纤维蛋白原水平比较,差异无统计学意义(P>0.05);治疗后,两组患者D-二聚体水平均显著降低,且实验组显著低于对照组,差异存在统计学意义(P<0.05);两组患者纤维蛋白原水平均显著提高,但实验组显著低于对照组,差异存在统计学意义(P<0.05);治疗前,两组患者肢体周径比较,差异无统计学意义(P>0.05);治疗后,两组患者肢体周径均显著降低,且实验组显著低于对照组,差异比较存在统计学意义(P<0.05);实验组患者DVT发生率显著低于对照组,差异比较存在统计学意义(P<0.05)。结论关节置换术后,给予患者4 h/d的IPCD治疗,DVT预防效果显著优于2 h/d,同时可有效调节D-二聚体以及纤维蛋白原水平、缩短患者肢体周径,值得临床推广应用。

Objective:The effect of duration of treatment with intermittent gradient compression devices(IPCD on deep venous thrombosis(DVT)after joint replacement was analyzed.Methods:60 patients undergoing joint replacement in our hospital from June 2021 to December 2021 were selected,and were divided into control group and experimental group by random number table method,with 30 cases in each group.All patients in both groups were treated with joint replacement,and were given IPCD after surgery.The control group was treated twice a day for 1 h each time.The experimental group was treated twice a day for 2 h each time.D-dimer level,fibrinogen level,limb circumference and the incidence of DVT in two groups were compared and analyzed.Results:Before treatment,there was no significant difference in d-dimer and fibrinogen levels between two groups(P>0.05).After treatment,d-dimer level in two groups was significantly decreased,and the experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05);Fibrin raw water in two groups was significantly increased,but the experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05);Before treatment,there was no significant difference in limb circumference between two groups(P>0.05).After treatment,limb circumference in two groups was significantly decreased,and the experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05);The incidence of DVT in the experimental group was significantly lower than that in the control group,with statistical significance(P<0.05).Conclusion:After joint replacement,IPCD treatment for 4 h/d was given to patients,and the prevention effect of DVT was significantly better than 2 h/d.Meanwhile,it can effectively regulate d-dimer and fibrinogen levels and shorten limb circumference of patients,which has high clinical application value.