多种方法预防慢性阻塞性肺疾病急性加重期患者下肢深静脉血栓形成的效果评价
Evaluation of the effect of multiple methods to prevent deep venous thrombosis of lower limbs in patients with acute exacerbation of chronic obstructive pulmonary disease
关淑君 1裴静璇 1洪炳 1钟益锴 1黄健 1张岚 1张露 1杨蓉美1
作者信息
- 1. 江西省胸科医院,江西南昌 330006
- 折叠
摘要
目的 探讨多种方法预防慢性阻塞性肺疾病急性加重期(AECOPD)患者下肢深静脉血栓形成(DVT)的效果.方法 采用随机数字表法将2022年2月-2023年3月医院收治的180例AE-COPD患者分为3组,各60例,其中肝素组采用低分子肝素干预,间歇性气压仪干预组采用间歇性气压仪干预,锻炼联合按摩组实施肢体锻炼联合穴位按摩干预,均干预7d,比较两组干预3d、7d时的凝血功能、血流动力学,统计两组DVT发生情况.结果 干预3d及干预7d时3组的凝血酶原时间(PT)、纤维蛋白原(Fib)、国际标准化比值(INR)、血小板(PLT)、部分活化凝血活酶时间(APTT)及D-二聚体(D-D)水平比较,无统计学差异(P＞0.05);干预7d时,3组PT、APTT均低于干预3d,PLT均高于干预3d,有统计学差异(P＜0.05);干预7d时,3组下肢静脉血流速度均较干预3d时高,且肝素组胭静脉、胫后静脉及股深静脉血流速度高于间歇性气压仪干预组、锻炼联合按摩组,有统计学差异(P＜0.05);3组干预3、7d时的DVT发生率比较,无统计学差异(P＞0.05).结论 AECOPD患者采用低分子肝素、间歇性气压仪及肢体锻炼联合穴位按摩干预均可有效预防DVT发生.
Abstract
Objective To investigate the effect of multiple methods to prevent deep vein thrombo-sis(DVT)of lower limbs in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 180 patients with AECOPD admitted to hospital from February 2022 to March 2023 were divided into 3 groups with 60 cases each by random number table meth-od.Low molecular weight heparin intervention was applied in heparin group,intermittent baro-metric intervention was applied in intermittent barometric intervention group,and physical exer-cise combined with massage group was applied in combination with acupoint massage intervention for 7 days.The coagulation function and hemodynamics of the two groups were compared after 3 and 7 days of intervention,and the incidence of DVT in the two groups was statistically analyzed.Results There were no significant differences in the levels of prothrombin time(PT),fibrinogen(Fib),International normalized ratio(INR),platelet(PLT),partially activated thromboplastin time(APTT)and D-dimer(D-D)between 3 groups after intervention for 3 days and 7 days(P＞0.05).After 7 days of intervention,PT and APTT in 3 groups were lower than that in interven-tion 3d,and PLT was higher than that in intervention 3d,with statistical difference(P＜0.05).After intervention for 7 days,blood flow velocity of lower limb veins in 3 groups was higher than that in intervention for 3 days,and blood flow velocity of popliteal vein,posterior tibial vein and deep femoral vein in heparin group was higher than that in intermittent barometric intervention group and exercise combined massage group,with statistical difference(P＜0.05).There was no significant difference in the incidence of DVT among 3 groups at 3 and 7 days of intervention(P＞0.05).Conclusion The intervention of low molecular weight heparin,intermittent barom-eter and limb exercise combined with acupressure can effectively prevent the occurrence of DVT in AECOPD patients.
关键词
慢性阻塞性肺疾病急性加重期/肝素/间歇性气压仪/下肢深静脉血栓形成Key words
Acute exacerbation of chronic obstructive pulmonary disease/Heparin/Intermittent barometer/Deep venous thrombosis of lower extremity引用本文复制引用
基金项目
江西省卫生健康委科技计划项目(202311088)
出版年
2024
NETL
NSTL
万方数据