重症监护病房住院患者发生静脉血栓的风险和预防措施

Risk of venous thromboembolism in patients of intensive care unit and its preventive measures

目的:观察ICU患者静脉血栓形成(VTE)的风险,评估间歇充气加压治疗(IPC)对VTE的临床预防作用。方法:选择ICU住院患者326例,随机分为对照组和IPC观察组,每组163例,采用Caprini量表进行VTE风险评估。结果:326例ICU患者Caprini评分为(9.3±2.3)分,其中无风险占2.15%,低风险占5.52%,中风险占10.12%,高风险占15.95%,极高风险占66.26%。相关性分析显示Caprini评分与患者的性别和年龄之间无显著的相关性(P>0.05),但与患者的APACHEⅡ评分呈显著的正相关(r=0.416,P<0.05)。对照组ICU住院时间显著长于观察组(P<0.05)。VTE发生率观察组显著低于对照组(4.91%vs16.56%,P<0.05)。结论:ICU病房患者存在VTE高风险,IPC可以显著减低VTE发生率。

Objective ： To observe the risk of developing venous thromboembolism （VTE） in patients of intensive care u- nit （ICU）, and to estimate the clinical preventive effect of intermittent pneumatic compression （IPC） on VTE. Methods： A total of 326 cases in ICU were selected and divided into control group and IPC observation group, 163 cases for each group. Caprini scale was used for VTE risk assessment. Results： In 326 cases of ICU patients, Caprini score was （9.3± 2.3） , a- mong which no risk patients accounted for 2.15% , low risk patients accounted for 5.52% , medium risk patients accounted for 10.12% , high risk patients accounted for 15.95% of, and very high risk patients accounted for 66.26%. Correlation a- nalysis showed that Caprini score had no significant correlation with patients sex and age （ P 〉 0.05 ）, but showed signifi- cantly positive correlation with APACHE U scores （ r = 0. 416, P 〈 0.05 ）. The duration of ICU hospitalization in control group was significantly longer than that in observation group （P 〈 0.05 ）. The incidence of VTE in observation group was sig- nificantly lower than that of control group （ 4.91% vs 16.56% ,P 〈0.05）. Conclusions： ICU patients have high risk of VTE. IPC can significantly reduces the incidence of VTE in ICU patients.