穴位按摩对老年全髋关节置换术后DVT的预防

Prevention of DVT After Senile Total Hip Arthroplasty By Acupressure

目的探讨穴位按摩联合早期功能锻炼对预防老年全髋关节置换术后下肢深静脉血栓形成(DVT)临床应用效果。方法选取我院外科2016年1月-2019年5月间行全髋关节置换术的老年患者40例,随机分为对照组和观察组各20例。对照组给予常规护理,观察组在对照组基础上配合穴位按摩及早期功能锻炼措施。干预2周,对比两组手术前后下肢周径变化、D-二聚体情况(D-D),相关凝血指标变化包括凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)及DVT发生率和满意度。结果两组术前术后下肢周径数据、PT、TT、FIB组间比较差异无统计学意义(P>0.05);观察组术后D-D监测水平、DVT发生率低于对照组,观察组满意度高于对照组,差异均有统计学意义(P<0.05)。结论穴位按摩及早期功能锻炼措施可改善老年髋关节置换术后高凝状态,降低术后血栓发生危险,提高患者满意度,且操作简便易行。

Objective To explore the clinical application of acupoint massage combined with early functional exercise in the prevention of deep venous thrombosis(DVT)of the elderly after total hip arthroplasty.Methods Forty elderly patients who underwent total hip arthroplasty from January 2016 to May 2019 in the Department of Surgery of our hospital were randomly divided into a control group and an observation group of 20 cases each.The control group was given routine care,and the observation group was supplemented with acupoint massage and early functional exercises on the basis of the control group.After 2 weeks of intervention,the changes in the circumference of the lower limbs and D-dimer(DD)before and after surgery were compared between the two groups.The changes in relevant blood coagulation indicators include prothrombin time(PT),thrombin time(TT),and fibrinogen(FIB).And DVT incidence and satisfaction.Results Preoperative and postoperative lower extremity circumference data,PT,TT,and FIB were not significantly different between the two groups(P>0.05);the postoperative DD monitoring level and the incidence of DVT in the observation group were lower than those in the control group,and the observation group was satisfied higher than the control group,the differences were statistically significant(P<0.05).Conclusion Acupoint massage and early functional exercise nursing measures can improve the hypercoagulable state after hip replacement in the elderly,reduce the risk of postoperative thrombosis,improve patient satisfaction,and the operation is simple and easy.