自制分层搭扣式脚垫在髋关节置换术患者中的应用

Application of serf-made layering fibula feet cushion to prevent deep venous thrombosis after hip replacement

目的评价自制分层搭扣式脚垫在预防髋关节置换术（HR）术后下肢深静脉血栓（DVT）的疗效。方法将100例符合入组标准的患者随机分成两组，每组50例，研究组使用分层搭扣式脚垫预防DVT，对照组使用普通脚垫预防DVT，比较两组患者深静脉血栓发生率、患肢肿胀消退时间、Harris髋关节功能评分和住院时间。结果住院时间研究组为（6．80±1．26）d，对照组为（7．47±1．81）d；肿胀消退时间，研究组为（4．47±1．28）d，对照组为（4．90±1．75）d；两组住院时间和肿胀消退时间比较差异均有统计学意义（t值分别-3．034，-1．986；P〈0．05）；深静脉血栓发生率，研究组为4％，对照组为14％；Harris髋关节功能评分改善上，研究组有效率为96％，对照组有效率为82％，两组深静脉血栓发生率及骨关节功能改善率比较差异均有统计学意义（x^2值分别为4．031，-3．129；P〈0．05）。结论自制分层搭扣式脚垫能有效预防HR术后DVT的发生，可以在临床加以推广应用。

Objective To evaluate the curative effect of self-made layering fibula feet cushion to prevent deep venous thrombosis（DVT） after hip replacement （HR）. Methods Totals of 100 patients applied THA divided into two groups-experimental group and control group on average randomly. The experimental group utilized self-made layering fibula feet cushion while the control group applied general feet cushion to prevent DVT. To compare the rate of DVT, the length of swelling vanishment, Harris hip score and the length of hospitalization had been used as effect evaluation. Results Comparing with control group, the rate of DVT （14%）, the length of swelling vanishment （4. 90 ± 1.75 ） d, Harris hip score （ 82% ） and the length of hospitalization experimental group（7.47 ± 1.81 ） d, the experimental group acquired 4%, （4.47 ± 1.28 ） d, 96% and （6.80 ± 1.26） d,respectively. The length of hospitalization and the length of swelling vanishment had statistical significance （t = - 3.034, - 1. 986, respectively; P 〈 0. 05）. The results of rate of DVT and the rate of hip functional improvement had statistical significance as well （X^2 = 4. 031, -3. 129, respectively; P 〈 0.05）. Conclusions The self-made layering fibula feet cushion can effectively prevent DVT after total hip replacement and are strongly recommended for clinic nursing comprehensively.