神经肌肉电刺激联合低分子肝素预防高血压性脑出血偏瘫患者下肢静脉血栓的临床疗效

Clinical efficacy of neuromuscular electrical stimulation combined with low molecular weight heparin in the prevention of lower limb venous thrombosis in patient with hypertensive intracerebral hemorrhage and hemiplegia

目的观察神经肌肉电刺激联合低分子肝素预防高血压性脑出血偏瘫患者下肢静脉血栓的临床疗效。方法120例高血压性脑出血偏瘫患者随机分为两组,每组60例。观察组采用神经肌肉电刺激联合低分子肝素治疗,对照组单用神经肌肉电刺激治疗。比较两组下肢静脉血栓发生情况、腘静脉和股静脉血流速度、D-二聚体水平、血小板计数以及凝血综合指数(CI)变化。结果观察组深静脉血栓和肌间静脉血栓发生率低于对照组(P<0.05)。与神经肌肉电刺激前相比,两组神经肌肉电刺激时腘静脉、股静脉血流速度均增加(P<0.05),但两组间比较差异无统计学意义(P>0.05)。与入院时相比,观察组神经肌肉电刺激第7天时D-二聚体水平和血小板计数增加(P<0.05),而对照组神经肌肉电刺激第3、7天时CI、D-二聚体水平及血小板计数均增加(P<0.05);观察组神经肌肉电刺激第3、7天时CI、D-二聚体水平和血小板计数低于对照组(P<0.05)。结论与单用神经肌肉电刺激比较,联合应用低分子肝素治疗能有效预防高血压性脑出血偏瘫患者下肢静脉血栓形成。

Objective To observe the clinical efficacy of neuromuscular electrical stimulation combined with low molecular weight heparin in the prevention of lower limb venous thrombosis in the patients with hypertensive intracerebral hemorrhage and hemiplegia.Methods A total of 120patients with hypertensive intracerebral hemorrhage and hemiplegia were equally randomized into two groups of A and C.The patients in group A accepted the neuromuscular electrical stimulation combined with low molecular weight heparin,while whose in group C only received the neuromuscular electrical stimulation.The incidence of lower limb venous thrombosis,blood flow velocities of popliteal and femoral vein,D-dimer level,platelet count and coagulation index(CI)were compared between groups of A and C.Results The incidences of deep and intermuscular venous thrombosis in group A were higher than those in group C(P<0.05).Compared with before neuromuscular electrical stimulation,the blood flow velocities of popliteal and femoral vein were increased in both groups during the neuromuscular electrical stimulation(P<0.05),whereas there was no statistical difference in the blood flow velocities of popliteal and femoral vein between groups of A and C(P>0.05).Compared with admission,the D-dimer level and platelet count were increased on the 7th day after the neuromuscular electrical stimulation in group A(P<0.05),while the CI,D-dimer level and platelet count were all increased on the 3rd and 7th day after the neuromuscular electrical stimulation in group C(P<0.05).Moreover,the CI,D-dimer level and platelet count on the 3rd and 7th day after the neuromuscular electrical stimulation in group A were lower than those in group C(P<0.05).Conclusion Compared to neuromuscular electrical stimulation,combined use of low molecular weight heparin treatment can effectively prevent the lower limbs venous thrombosis in the patients with hypertensive intracerebral hemorrhage and hemiplegia.