梯度压力袜联合间歇充气加压在老年新型冠状病毒肺炎患者预防下肢深静脉血栓形成中的应用

Application of gradient pressure socks combined with intermittent pneumatic compression in the prevention of lower limb deep vein thrombosis in elderly patients with novel coronavirus pneumonia

目的探讨梯度压力袜(gradient compression stockings,GCS)联合间歇充气加压(intermittent pneumatic compression,IPC)在老年新型冠状病毒肺炎(corona virus disease 2019,COVID-19)患者预防下肢深静脉血栓形成(lower extremity deep vein thrombosis,LEDVT)中的应用效果。方法纳入2022年11月至2023年1月南京医科大学附属南京医院老年COVID-19患者60例,通过在线随机数字生成器随机分为观察组和对照组,每组各30例。对照组给予常规预防干预,观察组在常规干预的基础上采用GCS联合IPC物理干预。对比分析两组患者活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、双侧股静脉血流速度、血清肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)、患者满意度、下肢肿胀和LEDVT的发生率。结果两组患者一般资料比较,差异无统计学意义(P>0.05)。观察组APTT、TT、双侧股静脉血流速度均高于对照组,差异有统计学意义(P<0.05);观察组下肢肿胀及LEDVT发生率、TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05);观察组患者满意度显着高于对照组,差异有统计学意义(P<0.05)。结论GCS联合IPC能改善老年COVID-19患者的凝血功能,减轻炎症反应,增加双侧股静脉血流速度,显著降低LEDVT的发生率。

Objective To explore the effect of gradient compression stockings(GCS)combined with intermittent pneumatic compression(IPC)in the prevention of lower extremity deep vein thrombosis(LEDVT)in elderly patients with corona virus disease 2019(COVID-19).Methods Sixty elderly patients with COVID-19 in our hospital from November 2022 to January 2023 were selected and randomly divided into observation group and control group through an online random number generator,with 30 cases in each group.The control group was given routine preventive intervention,while the observation group was given GCS combined with IPC inflation and compression intervention on the basis of routine intervention.The activated partial thromboplastin time(APTT),thrombin time(TT),bilateral femoral vein blood flow velocity,serum tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),patient satisfaction,occurrence rate of lower limb edema,and incidence rate of LEDVT were compared between the two groups.Results There was no statistically significant difference in general data between the two groups of patients(P>0.05).APTT,TT and bilateral femoral vein blood flow velocity in observation group were higher than those in control group,with statistically significant difference(P<0.05).The incidence of lower limb swelling and LEDVT,TNF-αand IL-6 levels observation group were lower than those in control group(P<0.05).The satisfaction of patients in observation group was significantly higher than that in control group(P<0.05).Conclusion GCS combined with IPC can improve the coagulation function of elderly patients with COVID-19,reduce inflammatory reaction,increase the blood flow velocity of bilateral femoral veins,and significantly reduce the incidence of LEDVT.