康复治疗与抗凝措施预防长期卧床患者并发深静脉血栓的效果

Clinical Comparison of Rehabilitation Therapy and Anti-coagulation in Preventing deep Venous Thrombosis and Other Complications in long-term Bedridden Patients

目的探讨康复治疗方法与抗凝预防长期卧床患者深静脉血栓及其他并发症的效果。方法病例为医院长期卧床治疗患者120例,根据就诊先后顺序分为3组,各40例,A组给予康复治疗,B组给予抗凝治疗,C组给予康复治疗联合抗凝,观察3组血小板计数(PLT)、凝血指标、血液流变学变化;记录下肢深静脉血栓(DVT)、并发症发生率及抗凝治疗期间不良用药反应。结果 C组治疗后PLT、t-PA显著高于A组、B组,D-D、Fbg低于A组、B组,差异显著(P<0.05);A组、B组组间差异显著(P<0.05);C组治疗后前血浆黏度、全血高切黏度、全血低切黏度显著低于A组、B组(P<0.05);A组、B组组间差异显著(P<0.05)。3组DVT发生率无明显差异(P>0.05);A组、C组出现不良用药反应几率分别为12.5%、10.0%。结论康复治疗方法与抗凝预防长期卧床患者DVT效果显著,且能够降低并发症发生率。

Objective To investigate the effects of rehabilitation therapy and anti-coagulation in preventing deep venous thrombosis( DVT) and other complications in long-term bedridden patients. Methods120 cases of long-term bedridden patients receiving treatment were divided into 3 groups according to the order of treatment,with 40 cases in each group. Group A were given rehabilitation therapy while group B were given anticoagulant therapy and group C were given rehabilitation therapy combined with anti-coagulation. The changes of platelet count( PLT),blood coagulation indexes and hemorheology in the 3 groups were observed; The incidence rates of deep venous thrombosis( DVT) and complications and adverse drug reactions during anticoagulant therapy were recorded. Results After treatment,PLT and t-PA of group C were significantly higher than those of group A and B while D-D and Fbg were lower than those of group A and B( P < 0. 05); The differences between group A and B were significant( P < 0. 05); After treatment,plasma viscosity,whole blood high shear viscosity and whole blood low shear viscosity of group C were significantly lower than those of group A and B( P < 0. 05); The differences between group A and B were significant( P < 0. 05). There were no statistically significant differences in the incidence rates of DVT between the 3 groups( P > 0. 05); The incidence rates of adverse drug reactions in group A and C were 12. 5% and 10. 0% respectively. Conclusion The effects of rehabilitation therapy and anti-coagulation in preventing DVT in patients long-term lying in bed are significant and they can reduce the incidence of complications.