早期主动功能康复对预防髋部术后深静脉血栓形成的影响

The Effect of Early Active Rehabilitation on Prevention of Deep Venous Thrombosis in Patients After Hip Surgery

目的探讨早期主动功能康复对于预防髋部术后患者深静脉血栓(DVT)形成的影响。方法选择2016年1月至2017年12月于我院行髋部手术患者96例,以随机数字表将其分为两组,即对照组与研究组,每组各48例。对照组术后注射低分子肝素、术侧小腿按摩、卧床休息。研究组在对照组药物治疗的基础上,由治疗医师指导开展早期主动功能康复干预。评价两组患者术前与术后7d时血流动力学指标、大腿与小腿周径的变化,以及术后DVT的发生率、住院时间。结果研究组术后7d时股静脉血流峰速与平均速度均高于对照组,差异具有统计学意义(P<0.05)。研究组术后7d时大腿周径与小腿周径均低于对照组,差异具有统计学意义(P<0.05)。研究组术后DVT发生率3.64%低于对照组16.36%(P<0.05)。研究组住院时间为(11.8±2.4)d,低于对照组的(15.3±3.8)d(P<0.05)。结论早期主动功能康复对DVT形成具有显著的预防作用,适于临床应用。

Objective To explore the effect of early active rehabilitation on the prevention of deep venous thrombosis（DVT）after hip surgery.Methods Ninety-six patients who underwent hip surgery in our hospital from January 2016 to December 2017 were randomly divided into two groups according to a random number table,namely control group and study group,48 cases in each group.In the control group,low molecular weight heparin and calf massage on the side of the operation and bed rest were injected postoperatively.On the basis of drug treatment in the control group,the study group was guided by the treating physician to carry out early active rehabilitation intervention.Evaluated the hemodynamic parameters,the circumference of the thigh and calf,and the incidence of postoperative DVT and hospitalization time before and 7 days after operation in the two groups of patients.Results The peak velocity and mean velocity of femoral vein blood flow in the study group were higher than those in the control group on the 7 th day after surgery（P〈0.05）.The diameters of the thigh circumference and calf circumference at the 7 th day in the study group were lower than those in the control group,and the difference was statistically significant（P〈0.05）.The incidence of postoperative DVT in the study group was 3.64%,which was significantly lower than that in the control group（16.36%）（P〈0.05）.The length of stay in the study group was（11.8±2.4）days,which was lower than that of the control group（15.3±3.8 days）（P〈0.05）.Conclusion Early active rehabilitation has a significant preventive effect on the formation of DVT and it is suitable for clinical application.