下足部推拿联合穴位贴敷对预防老年髋部骨折患者术后发生下肢深静脉血栓的作用

Effect of thenar massage combined with acupoint application on the prevention of lower limb deep vein thrombosis after surgery for hip fracture in elderly patients

目的考察下足部推拿联合穴位贴敷预防老年髋部骨折患者术后发生下肢深静脉血栓(DVT)的效果。方法选取2021年2月至2022年10月在常州市中医医院接受手术治疗的90例老年髋部骨折患者作为研究对象,根据干预方法的差异分为对照组和观察组,每组45例。对照组给予常规护理,在其基础上,观察组给予下足部推拿联合穴位贴敷。比较2组的护理干预效果。结果观察组的DVT发生率(2.22%)低于对照组(13.33%,P<0.05)。2组在术后3 d和10 d的D-二聚体、纤维蛋白原水平,以及血浆黏度、全血黏度均低于术后1 d,患侧下肢血流速度均快于术后1 d(P均<0.05),且术后10 d均优于术后3 d(P均<0.05);观察组在术后3 d及10 d的上述指标均优于同期对照组(P均<0.05)。2组在术后3 d和10 d的视觉模拟评分法(VAS)评分均低于术后1 d,舒适状况量表(GCQ)和健康调查简表(SF-36)评分均高于术后1 d(P均<0.05),且术后10 d均优于术后3 d(P均<0.05);观察组在术后3 d及10 d的各项评分均优于同期对照组(P均<0.05)。结论下足部推拿联合穴位贴敷可有效预防老年髋部骨折患者术后DVT形成,改善其凝血功能和血液流变学指标,加速下肢血液流动,减轻术后疼痛,提高生活质量和舒适度。

Objective To investigate the effect of thenar massage combined with acupoint application on the prevention of lower limb deep vein thrombosis(DVT)in elderly patients after surgery for hip fracture.Methods Ninety elderly patients with hip fracture who underwent surgical treatment at Changzhou Hospital of Traditional Chinese Medicine from February 2021 to October 2022 were selected as the research subjects.They were divided into a control group and an observation group based on the differences in intervention methods,with 45 cases in each group.The control group received routine care,while the observation group additionally received thenar massage combined with acupoint application.The nursing intervention effect between the two groups was compared.Results The incidence of DVT in the observation group was lower than that in the control group(2.22%vs.13.33%,P<0.05).The levels of D-dimer,fibrinogen,plasma viscosity,and whole blood viscosity of both groups at 3 and 10 days after surgery were lower than those at 1 day after surgery,and the blood flow velocity of the affected lower limb was faster than that at 1 day after surgery(all P<0.05).The above parameters at 10 days after surgery were better than those at 3 days after surgery(all P<0.05).The observation group were superior to the control group at 3 and 10 days after surgery(all P<0.05).The Visual Analogue Scale(VAS)scores of both groups at 3 and 10 days after surgery were lower than those at 1 day after surgery,and the scores of the General Comfort Questionnaire(GCQ)and Short Form-36 Health Survey(SF-36)were higher than those at 1 day after surgery(all P<0.05).The above scores at 10 days after surgery were better than those at 3 days after surgery(all P<0.05).The observation group had better scores than the control group at 3 and 10 days after surgery(all P<0.05).Conclusion Thenar massage combined with acupoint application can effectively prevent the postoperative DVT in elderly patients with hip fracture,improve their coagulation function and hemorheological parameters,accelerate their lower limb blood flow,alleviate their postoperative pain,and improve their quality of life and comfort.