系统早期活动方案降低关节置换术后深静脉血栓形成风险的研究

Clinical effect of early exercises of patients to reduce the risk of deep vein thrombosis following total joint replacement

目的制定系统早期活动方案,了解其预防深静脉血栓形成(deep venous thrombosis,DVT)的临床效果。方法将102例实施髋、膝关节置换的骨科住院患者随机分成实验组和对照组,实验组实施系统早期活动方案,对照组给予目前临床预防DVT的护理常规。分别在术前及术后12d内观察两组患者DVT的相关症状;测量术前及术后第7天血浆D-二聚体水平。结果实验组术后早期DVT相关症状少于对照组;在术后第7天实验组血浆D-二聚体水平明显低于对照组。结论系统早期活动方案能够减轻关节置换患者术后DVT的相关症状并可降低血液高凝状态,对降低DVT发生风险有效。

Objective To demonstrate the effect of early exercises of patients to reduce the risk of deep vein thrombosis following total joint replacement. Methods In this study, 102 patients undergoing total hip replacement or total knee replacement were randomly divided into two groups. The experimental group （n=50） began exercise early on the day of surgery with the assist of a special mechanical device. The control group（n=52） began exercise after the day of surgery without the device according to nursing routine for prophylaxis of DVT. Symptoms may related to DVT were measured on pre-operation and 12 days after operation. The blood D-Dimer and coagulation status were tested on pre-operation and the 7th day after operation. Results The symptoms related to DVT were much more obvious in control group than in the experimental group with signifi- cant difference. The plasma levels of D-Dimer were much higher in control group than those in experimental group on the 7th day after operation. Conclusions Starting exercise earlier on the day of surgery with the assist of a special mechanical device could reduce the risk of deep vein thrombosis after total joint replacement arthroplasty.