间歇性充气压力泵预防髋关节置换术后下肢深静脉血栓

Intermittent pneumatic pressure pump in preventing deep vein thrombosis of lower limbs after hip arthroplasty

目的:探讨间歇性充气压力泵应用于髋关节置换术后对预防下肢深静脉血栓形成的效果。方法:选择2020年7月至2021年7月南京大学医学院附属鼓楼医院收治的行髋关节置换术的患者158例,随机分为两组,各79例。对照组术后采用依诺肝素钠注射液抗凝治疗,观察组在此基础上应用间歇性充气压力泵。对比两组下肢深静脉血栓发生率、肺栓塞发生率、下肢肿胀程度、手术前后负性情绪及髋关节功能变化。结果:观察组下肢深静脉血栓发生率低于对照组(P<0.05);观察组肺栓塞发生率与对照组相比,差异无统计学意义(P>0.05);观察组术后下肢肿胀程度轻于对照组(P<0.05);观察组术后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均低于对照组(均P<0.001);观察组术后3个月髋关节疼痛、活动度、功能评分高于对照组,畸形评分低于对照组(均P<0.001)。结论:间歇性充气压力泵应用于髋关节置换术后可有效预防下肢深静脉血栓形成,减轻下肢肿胀程度和负性情绪,改善髋关节功能。

Objective:To investigate the effect of intermittent pneumatic pressure pump applied to the prevention of deep vein thrombosis of lower limbs after hip arthroplasty.Methods:A total of 158 patients undergoing hip arthroplasty admitted to Drum Tower Hospital,Nanjing University School of Medicine from July 2020 to July 2021 were selected and randomly divided into two groups,each group with 79 cases.The control group received enoxaparin sodium injection anticoagulation treatment after the operation,and the observation group received intermittent air pressure pump on this basis.The incidence of deep vein thrombosis,pulmonary embolism,swelling of the lower extremities,negative emotions before and after surgery,and changes in hip joint function were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(P<0.05);the incidence of pulmonary embolism in the observation group was not statistically different from that in the control group(P>0.05);the postoperative swelling of the lower limbs in the observation group was milder than that in the control group(P<0.05);the postoperative HAMA and HAMD scores of the observation group were lower than those of the control group(all P<0.001);the hip pain,range of motion and function scores of the observation group were higher than those of the control group at 3 months postoperatively,and the deformity score of the observation group was lower than that of the control group(all P<0.001).Conclusion:The application of intermittent pneumatic pressure pump after hip replacement can effectively prevent deep venous thrombosis of the lower extremities,reduce the swelling of the lower extremities and negative emotions,and improve the function of the hip joint.