人工全膝关节置换后连续被动运动患者的血凝状态

Effect of continuous passive motion on blood coagulation condition in patients with total knee joint replacement

背景:前期对连续被动运动的研究主要集中在改善关节活动度和缓解关节肿胀方面。目的:探讨连续被动运动对全膝关节置换后患者凝血状态及下肢深静脉血栓发生的影响。方法:80例全膝关节置换患者随机等分为试验组及对照组,对照组沿用传统的方法,实行常规治疗与护理加个人主动功能锻炼;试验组在对照组基础上,置换后24h开始使用CPM机进行患膝关节持续被动屈曲训练。比较置换后2周两组凝血综合指数及肢深静脉血栓的发生率。结果与结论:置换后2周试验组凝血综合指数为2.66±1.04,下肢深静脉血栓形成的发生率为2.5%;对照组凝血综合指数为3.98±1.36,下肢深静脉血栓形成的发生率为17.5%,两组比较,试验组凝血综合指数及下肢深静脉血栓形成的发生率明显低于对照组(P<0.05)。提示全膝关节置换后早期应用CPM机进行持续被动活动训练能改善凝血综合指数,改善患者的血凝状态,对预防人工全膝关节置换后下肢深静脉血栓形成有较好的效果。

BACKGROUND： Preliminary studies on continuous passive motion mainly concentrated on improving the range of motion and relieving the joint swelling. OBJECTIVE： To investigate the effect of continuous passive motion on blood coagulation condition and deep vein thrombosis of the lower extremity in patients after total knee joint replacement. METHODS： Eighty patients with total knee joint replacement were randomly divided into experimental group and control group. Patients in the control group were treated only with traditional way to help the patient move the knee by the nurse and combined with active functional exercise; patients in the experimental group were treated with continuous passive motion beginning at 24 hours postoperatively, and were also treated with traditional way to help the patient move the knee by the nurse. Cruor comprehensive index and incidence rate of deep vein thrombosis of the lower extremity were recorded at 2 weeks after replacement. RESULTS AND CONCLUSION： At 2 weeks after replacement, cruor comprehensive index was 2.66＋1.04 and 3.98＋1.36 in the experimental group and the control group, and the incidence rate of deep vein thrombosis of the lower extremity was 2.5% and 17.5% in the experimental group and control group. The results showed that the cruor comprehensive index and incidence rate of deep vein thrombosis of the lower extremity in the experimental group were lower than those in the control group （P 〈 0.05）. Early application of continuous passive mobilization after total knee joint replacement has obvious advantages in improving the cruor comprehensive index and blood coagulation condition and it has positive effect on protecting the deep vein thrombosis of the lower extremity.