神经肌肉及穴位电刺激预防剖宫产后下肢静脉血栓的应用研究

Application research on the neuromuscular and acupoint electrical stimulation to prevent venous thrombosis of lower limbs after cesarean section

目的 探讨神经肌肉及穴位电刺激对预防剖宫产术后下肢静脉血栓形成的临床疗效。方法 选取2018年4月至2019年10月在枣庄市妇幼保健院行剖宫产术产妇60例,随机分为对照组和观察组,每组30例。对照组接受产后产妇常规护理,观察组在对照组基础上增加神经肌肉及穴位电刺激。比较两组治疗前后活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)、纤维蛋白原(FIB)、血小板(PLT)的变化,采用超声检测两组患者治疗前后双下肢静脉血栓形成情况和静脉血流速度。结果 治疗后两组患者均无下肢深静脉血栓形成。观察组治疗后下肢静脉血流速度均高于治疗前和对照组,差异有统计学意义(P <0.05),而对照组治疗前后下肢静脉血流速度比较,差异无统计学意义(P> 0.05);观察组治疗后APTT和TT较治疗前和对照组延长,D-D、FIB、PLT较治疗前和对照组均降低,差异有统计学意义(P <0.05),对照组治疗前后凝血相关指标比较,差异无统计学意义(P> 0.05)。结论 对剖宫产术后产妇进行神经肌肉联合穴位电刺激可预防剖宫产术后下肢静脉血栓的形成。

Objective To investigate the clinical efficacy of neuromuscular and acupoint electrical stimulation to prevent venous thrombosis of lower limbs after cesarean section. Methods A total of 60 parturients who underwent cesarean section in Maternity and Child Health Care of Zaozhuang from April 2018 to October 2019were selected and randomly divided into the control group(n=30) and the observation group(n=30). The control group was treated with conventional postpartum nursing care for parturients, while the observation group was treated with neuromuscular and acupoint electrical stimulation based on the treatment of the control group. The changes of activated partial thromboplastin time(APTT), thrombin time(TT), D-dimer(D-D), fibrinogen(FIB)and platelet(PLT) were compared between the two groups before and after treatment. The venous thrombosis and venous blood flow velocity of both lower limbs were detected by ultrasound before and after treatment. Results After treatment, there was no deep venous thrombosis in both groups. The blood flow velocity of lower limb vein in the observation group after treatment was higher than that before treatment and in the control group, with a statistically significant difference(P < 0.05), while the blood flow velocity of lower limb vein in the control group before and after treatment was not statistically significant(P > 0.05);After treatment, APTT and TT in the observation group were longer than those before treatment and the control group, and D-D, FIB, PLT were lower than those before treatment and the control group, with statistically significant differences(P < 0.05).There was no statistically significant difference in coagulation related indicators before and after treatment in the control group(P > 0.05). Conclusion Neuromuscular electrical stimulation combined with acupoint electrical stimulation for parturients after cesarean section can prevent the formation of venous thrombosis of lower limbs after cesarean section.