气压治疗对重症急性胰腺炎患者凝血功能和下肢深静脉血栓形成的影响

Effects of barometric therapy on coagulation function and deep venous thrombosis of lower limbs in patients with severe acute pancreatitis

目的探讨气压治疗对重症急性胰腺炎患者凝血功能和下肢深静脉血栓形成的影响。方法选择2018年5月至2020年5月石家庄市人民医院收治的184例重症急性胰腺炎患者。依据随机数字表法将184例重症急性胰腺炎患者分为对照组(采用常规治疗方法)和观察组(在对照组的基础上采用气压治疗的方法),每组92例。比较两组患者的治疗效果和治疗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)、纤维蛋白原(Fib)]、下肢血流动力学指标(双下肢血流流速峰值、平均速度)。比较两组患者治疗期间下肢深静脉血栓形成的发生情况、医疗费用情况、不良反应发生情况。结果治疗后,观察组患者的PT、APTT、TT均长于对照组患者,Fib水平低于对照组患者(P<0.05)。治疗后,观察组患者的下肢血流流速峰值高于对照组患者,下肢血流平均速度快于对照组患者(P<0.05)。观察组患者下肢深静脉血栓形成的发生率低于对照组患者(P<0.05)。两组患者的医疗费用、不良反应发生情况比较,差异无统计学意义(P>0.05)。结论常规治疗联合气压治疗的方法能够在短期内有效改善重症急性胰腺炎患者的凝血功能,提高下肢血流速度,降低治疗期间下肢深静脉血栓形成的发生风险,不明显增加患者的经济负担,具有良好的安全性。

Objective To investigate the effect of barometric therapy on coagulation function and deep venous thrombosis of lower limbs in patients with severe acute pancreatitis.Method A total of 184 patients with severe acute pancreatitis who were admitted to Shijiazhuang People's Hospital from May 2018 to May 2020 were selected.According to the random number method,they were divided into control group(routine treatment)and observation group(pneumatic treatment on the basis of control group),with 92 cases in each group.The therapeutic effects of the two groups were compared,as well as the coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib)],lower limb hemodynamic indexes(peak blood flow velocity and average velocity of blood flow in both lower limbs)before and after treatment in the two groups of patients.The incidence of lower limb deep venous thrombosis,medical expenses and adverse reactions were compared between the two groups.Result After treatment,the observation group's PT,APTT,TT,peak blood flow velocity and average velocity of blood flow of the lower limbs were higher than those of the control group,and the level of Fib of the observation group was lower than that of the control group(P<0.05).The incidence rate of deep vein thrombosis of the lower limbs in the observation group was lower than that in the control group(P<0.05).There was no significant difference in medical expenses and adverse reactions between the two groups(P>0.05).Conclusion Incorporating barometric therapy combined with routine therapy into the treatment of patients with severe acute pancreatitis can effectively improve blood coagulation indicators in a short period of time,increase blood flow speed of the lower extremities,reduce the risk of deep vein thrombosis in the lower extremities during treatment,and do not significantly increase the economic burden of patients.It has good safety.