足踝主动屈伸运动对骨科术后发生下肢深静脉血栓的预防作用

Preventive effect of active ankle flexion and extension exercise on deep venous thrombosis of lower limbs after orthopedic surgery

目的探究足踝主动屈伸运动对骨科手术后发生下肢深静脉血栓(DVT)的预防作用。方法选取2020年3月至2021年3月于湖北六七二中西医结合骨科医院接受骨科手术的104例患者为研究对象,随机分为对照组和观察组,每组各52例。对照组予以常规护理,观察组在对照组基础上增加足踝主动屈伸运动。比较两组术后1个月内DVT发生率及术前1 d、术后7 d时下肢周径(大腿、小腿)、股静脉血流动力学[血流峰速度(Vmax)、血流量(Q)、血流速增大时维持时间(T)]。结果观察组术后DVT发生率显著低于对照组(P<0.05)。观察组术后大腿周径、小腿周径均明显小于对照组(P<0.05)。观察组术后股静脉Vmax、Q、T均高于对照组(P<0.05)。结论足踝主动屈伸运动可有效降低骨科手术患者术后DVT发生率,缓解患者下肢肿胀,改善股静脉血流动力学,对预防术后DVT有积极作用。

Objective To explore the preventive effect of active ankle flexion and extension exercise on deep venous thrombosis(DVT)of lower limbs after orthopedic surgery.Methods A total of 104 patients who underwent orthopedic surgery in Hubei 672 Orthopaedics Hospital of Integrated Chinese and Western Medicine from March 2020 to March 2021 were selected as research objects.They were randomly divided into the control group and the observation group,with 52 cases in each group.T he control group was given conventional nursing,while the observation group was given active ankle flexion and extension exercise on the basis of conventional nursing in the control group.The incidence of DVT within one month after operation,the circumference of lower limbs(thighs and legs)1 day before operation and 7 days after operation and femoral vein hemodynamics(peak velocity of blood flow[Vmax],blood flow[Q],and maintenance time when blood flow rate increases[T])were compared between the two groups.Results The incidence of DVT in the observation group was significantly lower than that in the control group(P<0.05).The thigh circumference and leg circumference in the observation group were significantly smaller than those in the control group(P<0.05).The Vmax,Q and T of femoral vein in the observation group after operation were significantly higher than those in the control group(P<0.05)Conclusion Active ankle flexion and extension exercise can effectively reduce the incidence of DVT after orthopedic surgery,relieve the swelling of lower limbs,improve the hemodynamics of femoral vein,and play a positive role in preventing DVT after surgery.