足底动静脉泵对人工股骨头置换术后下肢深静脉血栓形成的预防效果

Preventive effect of planar arteriovenous pump on lower extremity DVT after artificial femoral head replacement

目的探讨足底动静脉泵对于人工股骨头置换术后下肢深静脉血栓形成(DVT)的预防效果。方法收集2019年1月至2021年1月在北京老年医院接受人工股骨头置换术治疗的102例患者临床资料,从中选取术后应用常规DVT预防措施的51例患者作为常规组,选取术后应用足底动静脉泵预防DVT的51例患者作为观察组。比较两组患者的手术情况、术后恢复情况和术后DVT发生情况。比较两组患者干预前后的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)]及双下肢股静脉、腘静脉的血流速度。结果观察组患者的完全卧床时间、住院时间均明显短于观察组患者,差异有统计学意义(P<0.01)。观察组患者术后下肢DVT的发生率为3.92%(2/51),低于常规组患者的17.65%(9/51),差异有统计学意义(P<0.05)。干预后,观察组患者的PT、APTT、TT均长于常规组患者,FDP、D-D水平均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,观察组患者双下肢左股静脉、右股静脉、左腘静脉、右腘静脉的血流速度均快于常规组患者,差异均有统计学意义(P<0.05)。结论足底动静脉泵能够通过加快患者双下肢静脉血流速度,减轻患者术后血液高凝状态,提高对人工股骨头置换术后下肢DVT发生的预防效果,可于临床中进一步推广。

Objective To investigate the preventive effect of planar arteriovenous pump on lower extremity deep venous thrombosis(DVT)after artificial femoral head replacement.Method The clinical data of 102 patients who underwent artificial femoral head replacement in Beijing Geriatric Hospital from January 2019 to January 2021 were collected.Among them,51 patients who used routine DVT prevention measures after surgery were selected as the routine group,and 51 patients who received plantar arteriovenous pumps to prevent DVT after surgery were selected as the observation group.The surgery status,postoperative recovery status,and postoperative DVT occurrence of the two groups of patients were compared.The coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrin degradation product(FDP),D-dimer(D-D)]and the blood flow velocity of the femoral veins and popliteal veins of both lower limbs were compared between the two groups before and after the intervention.Result The total bedtime and hospital stay of the observation group were significantly shorter than those of the observation group,and the difference was statistically significant(P<0.01).The incidence rate of postoperative lower limb DVT in the observation group was 3.92%(2/51),which was lower than 17.65%(9/51)in the routine group,and the difference was statistically significant(P<0.05).After the intervention,the PT,APTT and TT of the observation group were longer than those of the routine group,and the FDP and D-D levels were lower than those of the routine group,the differences were statistically significant(P<0.05).After the intervention,the blood flow velocity of the left femoral vein,right femoral vein,left popliteal vein,and right popliteal vein of both lower limbs of the observation group was faster than that of the routine group,the difference was statistically significant(P<0.05).Conclusion The plantar arteriovenous pump could speed up patients’venous blood flow rate of the lower extremities,reduce the postoperative hypercoagulable states,and improve the prevention effect of lower extremity DVT after artificial femoral head replacement.This procedure should be further promoted in the clinical practice.