低分子肝素钠联合气压治疗用于卒中后深静脉血栓高危患者临床研究

Application of Low Molecular Weight Heparin Sodium Combined with Air Pressure Therapy in High-Risk Patients with Deep Vein Thrombosis After Stroke

目的探讨低分子肝素钠联合气压治疗在预防卒中后下肢深静脉血栓(DVT)高危患者中的作用及安全性。方法选取2016年8月至2018年5月医院就诊的脑卒中患者204例,采用Caprini评估表进行DVT风险因素评估,将筛选出的64例高危和极高危患者分为药物组(33例)和对照组(31例)。两组均行常规基础预防、肢体运动及气压治疗,药物组在此基础上,加用低分子肝素钠。结果药物组和对照组分别有1例和6例出现DVT,发生率有显著性差异(P<0.01);对照组肿胀、疼痛和皮肤颜色改变的发生率高于药物组(P<0.05);两组患者出院时颅内出血、牙龈出血、皮下瘀斑、消化道出血及其他部位出血的发生率相当(P>0.05)。结论低分子肝素钠联合气压可降低卒中后下肢深静脉血栓高危患者DVT发生率,减少患者下肢肿胀、疼痛等症状的发生,且安全有效。

Objective To investigate the effect and safety of low molecular weight heparin sodium combined with air pressure therapy in the prevention of deep vein thrombosis( DVT) in high-risk patients with stroke. Methods Totally 204 patients with stroke treated in our hospital from August 2016 to May 2018 were selected. The risk factors of DVT of lower extremities were assessed by Caprini assessment form,64 high-risk and extremely high-risk patients were divided into the drug group( n = 33) and the control group( n = 31).The patients in the two groups received routine basic prevention,limb movement and air pressure therapy. On this basis,the patients in the drug group were treated with low molecular weight heparin sodium. Results There was 1 case of DVT in the drug group and 6 cases in the control group,and the incidence of DVT in the two groups was significantly different( P < 0. 01). The incidence of swelling,pain and skin color change in the control group was higher than that in the drug group( P < 0. 05). There was no significant difference in the incidence of intracranial hemorrhage,gingival hemorrhage,subcutaneous ecchymosis,gastrointestinal hemorrhage and the other hemorrhage between the two groups at discharging( P > 0. 05). Conclusion Low molecular weight heparin sodium combined with air pressure therapy can reduce the incidence of DVT in high-risk patients with DVT of lower extremities after stroke,reduce the occurrence of symptoms such as swelling and pain of lower extremities. It is safe and effective.