阿加曲班联合抗血栓压力泵预防ICU患者下肢深静脉血栓形成中的作用研究

Effects of argatroban combined with antithrombotic pressure pump on the prevention of deep vein thrombosis of lower extremity in ICU patients

目的研究阿加曲班联合抗血栓压力泵在预防ICU患者下肢深静脉血栓形成中的作用。方法收集2017年7月~2019年7月合肥市第三人民医院ICU重症患者共108例,分为A、B、C三组,A组37例接受阿加曲班+抗血栓压力泵治疗,B组41例接受抗血栓压力泵单一治疗,C组30例未采取预防治疗;观察三组患者1周后下肢深静脉血流速度及血栓形成情况;比较三组患者入院时第1天及入院后第3、5、7天纤维蛋白原(FIB)和D-二聚体情况。结果三组患者入院时FIB和D-二聚体比较无明显差异,A组入院后第3、5、7天FIB和D-二聚体指标均低于B和C组,A组患者下肢深静脉血流速度快于B组及C组,B组快于C组,差异有统计学意义(P<0.05);入院后1周A组DVT发生率0,B组2.4%,C组10.0%。结论使用抗血栓压力泵能够预防ICU中重症患者下肢深静脉血栓形成,联合阿加曲班能够明显降低深静脉血栓形成风险,此方案值得临床进一步推广。

Objective To study the role of argatroban combined with antithrombotic pressure pump in the prevention of deep vein thrombosis(DVT)of lower extremity in ICU patients.Methods A total of 108 critical patients in ICU of Hefei Third People's Hospital from July 2017 to July 2019 were collected and divided into three groups:group A,group B and group C.37 patients in group A received argatroban+antithrombotic pressure pump treatment,41 patients in group B received antithrombotic pressure pump alone,30 patients in group C did not take preventive measures.The blood flow velocity and DVT of lower extremity one week after treatment in three groups was observed;Fibrinogen(FIB)and D-dimer(D-D)in three groups at admission and on the 3rd,5th and 7th day after admission were compared.Results There was no significant difference in FIB and D-D between the three groups at the time of admission.FIB and D-D in group A were lower than those in group B and group C on the 3rd,5th and 7th day after admission.The blood flow velocity of deep vein in group A was faster than that in group B and group C,and that in group B was faster than that in group C,and the differences were statistically significant(P<0.05).The incidence of DVT in group A was 0,group B was 2.4%,and group C was 10.0%one week after admission.Conclusion Antithrombotic pressure pump can prevent DVT of lower extremity in ICU critical patients,and the combination of argatroban can significantly reduce the risk of DVT of lower extremity,which is worthy of further clinical promotion.