自我减压法在预防下肢骨折后深静脉血栓中的应用

Application of serf-decompression on preventing the risk of deep vein thrombosis after surgery of lower limb fractures

目的探讨自我减压法预防深静脉血栓形成的临床效果。方法将86例下肢骨折患者随机分为实验组42例和对照组44例，实验组采用自我减压法，对照组给予常规预防DVT护理。在术前及术后10d内观察两组患者DVT发生情况、疼痛情况及相关症状。结果实验组血栓发生率为4．76％，低于对照组的22．72％，差异有统计学意义（x2=5．776，P〈0．05）；两组患者术前及术后第10天疼痛得分比较，差异均无统计学意义（P〉0．05）；术后第3天，实验组患者疼痛得分为（2．34±0．73）分，低于对照组的（3．62±0．72）分，差异有统计学意义（t=-2．786，P〈0．05）；术前两组患者患肢踝关节上5cm、膝关节上10am及膝关节下10ClTI处肢体周径及表面温度比较，差异均无统计学意义（P〉0．05）；术后第3天实验组患者患肢踝关节上5cm、膝关节下10cm周径分别为（20．07±1．40），（32．02±4．10）cm，均小于对照组的（21．82±0．70），（37．18±2．52）cm，实验组患肢踝关节上5cm及膝关节下10am处表面温度分别为（34．85±I．07），（35．40±0．76）℃，均低于对照组的（36．38±0．92），（36．43±0．50）℃，差异均有统计学意义（t分别为-2．508，-2．393，-2．445，-2．554；P〈0．05）。结论早期自我减压方法能够有效降低术后DVT高发性和危险性，促进术后健康恢复。

Objective To explore the effect of Self-decompression on reducing the risk of deep vein thrombosis after surgery of lower limb fractures. Methods In this study, 86 patients undergoing surgery of lower limb fractures were randomly divided into two groups. The experimental group （n = 42）received the intervention of self-decompression before the day of surgery. The control group （ n = 44） done exercise according to nursing routine for prophylaxis of DVT. Occurrence and symptoms may related to DVT were measured in pre-operation and 10 days after operation. Results DVT occurrence rate of the experimental group was 4.76% significantly lower than 22. 72% that of control group （ P 〈 0. 05 ）. On the 3th day after operation, the limb surface temperature [ Ankle above 5 cm （34. 85 ± 1.07） vs （36.38 ± 0. 92）, Knee below 10 cm （35.40 ± 0.76） vs （36.43 ± 0.50） ], the swelling degree [ Ankle above 5 cm （ 20.07 ± 1.40 ） vs （ 21.82 ± 0.70 ）, Knee below 10cm （32.02±4.10） vs （37.18±2.52）] and the degree of pain [（2.34±0.73） vs （3.62±0.72）]in experimental group were significantly lower than that in control group （ P 〈 0.05 ）. Conclusions Starting self- decompression could reduce the risk of deep vein thrombosis after the surgery of lower limb fractures, and can promote patients＇ recovery.