间歇性充气加压不同治疗压力对预防重症长期卧床病人下肢深静脉血栓的效果研究

Effect of different intermittent inflation compression treatment pressure on prevention of deep venous thrombosis of lower limbs in severe long-term bedridden patients

目的:探讨间歇性充气加压(IPC)装置不同治疗压力对重症长期卧床病人下肢深静脉血栓的预防效果。方法:以120例重症长期卧床病人为研究对象。按照随机数字表法分为对照组、试验1组、试验2组。对照组采取30 mmHg,试验1组采取45 mmHg,试验2组采取60 mmHg,比较3组病人15 d内DVT发生率、治疗前后的D-二聚体(D-D)水平、双下肢股静脉峰值血流量及气压治疗套筒内深部组织损伤发生率。结果:3组病人DVT发生率比较差异无统计学意义(P>0.05);与治疗前相比,治疗后3组病人的D-二聚体水平明显降低(P<0.05),组间比较发现3组病人D-二聚体降低幅度为试验2组>试验1组>对照组(P<0.05);治疗前3组病人双下肢股静脉血流峰值差异无统计学意义(P>0.05),治疗后试验1组与试验2组的股静脉血流峰值较于对照组均明显增快(P<0.05和P<0.01);对照组深部组织损伤发生0例(0%),试验1组1例(2.5%),试验2组7例(17.5%),试验2组深部组织损伤发生率远高于对照组及试验1组(P<0.01和P<0.05)。结论:长期气压治疗的病人压力参数更推荐45 mmHg,可降低DVT发生率,改善机体凝血功能及病人下肢血液循环,同时避免深部组织损伤的发生。

Objective:To investigate the effect of different treatment pressures of intermittent inflation compression(IPC)device on the prevention of deep venous thrombosis(DVT)of lower limb in severe long-term bedridden patients.Methods:One hundred and twenty cases of critically ill long-term bedridden patients were selected as study subjects.They were divided into the control group,trial 1 group and trial 2 group randomly.The control group took 30 mmHg,the trial 1 group took 45 mmHg,and the trial 2 group took 60 mmHg.The incidence of DVT within 15 days,the D-dimer(D-D)levels before and after treatment,the peak blood flow in the femoral veins of both lower limbs and the incidence of deep tissue injury in the pneumatic therapy sleeve were compared among the three groups.Results:There was no statistically significant difference in the incidence of DVT among the three groups(P>0.05).Compared with the pre-treatment period,the D-dimer levels in the three groups decreased significantly after treatment(P<0.05),and the comparison between the groups revealed that the reduction of D-dimer in the three groups was trial group 2>trial group 1>control group(P<0.05).There was no statistically significant difference in the peak blood flow in the femoral veins of both lower limbs among the three groups before treatment(P>0.05).There was no statistically significant difference in the peak femoral venous blood flow between the three groups before treatment(P>0.05).After treatment,the peak femoral venous blood flow was significantly faster in both trial group 1 and trial group 2 compared with the control group(P<0.05 and P<0.01).NO case of deep tissue injury occurred in the control group(0%),1 case in trial group 1(2.5%),and 7 cases in trial group 2(17.5%),and the incidence of deep tissue injury in trial group 2 was much higher than that in the control group and trial group 1(P<0.05 and P<0.01).Conclusions:The pressure parameter of 45 mmHg is more recommended for the application in patients with long-term pneumatic therapy,which can reduce the incidence of DVT,improve the coagulation function of the body and the blood circulation of patients′lower limbs and avoid the occurrence of deep tissue injury at the same time.