首页|膝关节镜围手术期踝泵运动防治下肢深静脉血栓形成的疗效研究

膝关节镜围手术期踝泵运动防治下肢深静脉血栓形成的疗效研究

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目的 探讨膝关节镜围手术期踝泵运动防治下肢深静脉血栓形成的疗效。方法 选取2021年1月至2022年12月该院运动医学科收治的行膝关节镜前十字韧带重建术患者100例,采用简单随机抽样法分为全程组、术后组、抗凝组和对照组,每组25例。全程组入院开始即进行规范踝泵运动至出院;术后组手术当天麻醉清醒后即开始规范踝泵运动直至出院;抗凝组术后开始给予低分子肝素钠皮下注射预防血栓直至出院,不进行踝泵运动;对照组不行踝泵运动及药物预防血栓,术后按常规活动患肢。4组患者术前、术后第3天行D-二聚体、下肢血管彩色多普勒超声检查下肢血栓发生情况。结果 对照组患者中发生血栓6例,发生率为24。0%。术后组、全程组、抗凝组患者血栓发生率均为0。术后组、全程组、抗凝组患者血栓发生率与对照组比较,差异均有统计学意义(χ2=12。471,P<0。001)。高凝组和非高凝组患者身体质量指数比较,差异有统计学意义(P<0。05)。对照组患者高凝发生率[64。0%(16/25)]明显高于术后组[24。0%(6/25)]、全程组[12。0%(3/25)]和抗凝组[0(0/25)],差异均有统计学意义(P<0。05)。结论 规范的踝泵运动可有效预防膝关节镜围手术期下肢深静脉血栓形成,踝泵运动经济、实用,值得推广应用。
Study on the curative effect of ankle pump exercise in prevention and treatment of deep venous thrombosis of lower extremity during perioperative period of knee arthroscopic surgery
Objective To investigate the preventive effect of ankle pump exercise in the prevention and treatment of deep venous thrombosis of lower extremity during perioperative knee arthroscopy.Methods A total of 100 patients who underwent arthroscopic anterior cruciate ligament reconstruction in sports medicine department of our hospital from January 2021 to December 2022 were selected and divided into the whole course group,the postoperative group,the anticoagulation group and the control group by simple random sam-pling method,with 25 cases in each group.In the whole course group,patients received ankle pump exercise from admission to discharge.In the postoperative group,patients started ankle pump exercise immediately af-ter awaking from surgical anesthesia until discharge.In the anticoagulation group,hypodermic injection of low molecular weight heparin sodium was given to prevent thrombus until discharge,and ankle pump exercise was not performed.The control group could not exercise ankle pump and prevent thrombus with drugs,and the af-fected limb was moved regularly after surgery.D-dimer and lower limb blood vessel color Doppler ultrasound were performed before and on the 3rd day after operation to detect the occurrence of lower limb thrombosis in the four groups.Results A total of six cases of thrombus occurred in the control group(24.0%).The inci-dence of thrombus in the postoperative group,the whole course group and the anticoagulation group was 0.The incidence of thrombus in the postoperative group,the whole course group and the anticoagulation group was significantly different from that in the control group(χ2=12.471,P<0.001).There was a statistically significant difference in BMI between the hypercoagulable group and the non hypercoagulable group(P<0.05).The incidence of hypercoagulability in the control group[64.0%(16/25)]was significantly higher than that in the postoperative group[24.0%(6/25)],the whole course group[12.0%(3/25)],and the anti-coagulation group[0(0/25)],with statistical significance(P<0.05).Conclusion Regular ankle pump exer-cise during perioperative operation under knee arthroscopy could effectively prevent deep venous thrombosis of lower extremity.Ankle pump exercise is economical,practical and worth promoting and applying.

Lower extremity deep vein thrombosisAnkle pump exerciseKnee ArthroscopyPerioperative operation

李凯、李彦林、张琨、施青吕、施政良、王云坚、唐文婷

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昆明医科大学第一附属医院运动医学科,云南 昆明 650000

下肢深静脉血栓形成 踝泵运动 膝关节镜 围手术期

云南省骨关节疾病临床医学中心项目

ZX2019-03-04

2024

现代医药卫生
重庆市卫生信息中心

现代医药卫生

影响因子:0.758
ISSN:1009-5519
年,卷(期):2024.40(16)