摘要
目的探讨间歇性充气加压装置(IPC)对重症监护室(ICU)患者血流动力学及静脉血栓栓塞症(VTE)的影响。方法收集2016年1月至2021年1月首都医科大学附属北京世纪坛医院收治的90例ICU患者的临床资料,根据治疗方法的不同将其分为常规组(n=45,采用常规血栓防治方案)和IPC组(n=45,在常规组基础上采用IPC治疗方案)。治疗前后,比较两组患者双下肢股静脉血流动力学指标(血流峰速度、血流平均速度、血流量)、疼痛程度、肿胀程度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D)],统计两组患者VTE的发生率及其发生时间,比较两组患者的不良反应发生率。结果治疗后,两组患者血流峰速度、血流平均速度、血流量均高于本组治疗前,且IPC组患者上述指标均高于常规组患者,差异均有统计学意义(P<0.05)。治疗后,两组患者D-D、FIB水平均低于本组治疗前,PT、APTT、TT均长于本组治疗前,且IPC组患者D-D、FIB水平均低于常规组患者,PT、APTT、TT均长于常规组患者,差异均有统计学意义(P<0.05)。治疗后,两组患者视觉模拟评分法(VAS)评分、肿胀程度均低于本组治疗前,且IPC组患者上述指标均低于常规组患者,差异均有统计学意义(P<0.05)。IPC组患者VTE发生率低于常规组患者,差异有统计学意义(P<0.05)。两组患者VTE高发时间段均为入住ICU后的第1~3天。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论IPC治疗能够改善ICU患者的血流动力学指标及凝血功能,可降低VTE的发生风险,值得在临床上应用。
Objective To investigate the effect of intermittent pneumatic compression(IPC)on hemodynamics and venous thromboembolism(VTE)in intensive care unit(ICU)patients.Method The clinical data of 90 ICU patients admitted to Beijing Shijitan Hospital,Capital Medical University from January 2016 to January 2021 were collected.They were divided into routine group(n=45,given conventional thrombosis prevention regimen)and IPC group(n=45,given additional IPC treatment program on the basis of routine group)according to different treatment methods.The hemodynamic indexes(peak blood flow velocity,average blood flow velocity and blood flow),pain degree,swelling degree,coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-dimer(D-D)]of the two groups of patients before and after treatment were compared.The incidence and time of VTE in the two groups were counted.The incidence of adverse reactions in the two groups was compared.Result After the treatment,the peak blood flow velocity,average blood flow velocity,and blood flow in the two groups were higher than those before the treatment in the same group,and the foregoing indexes of the patients in the IPC group were higher than those in the routine group,the differences were statistically significant(P<0.05).After the treatment,the levels of D-D and FIB in the two groups were lower than themselves before the treatment,while PT,APTT,and TT were longer than those before treatment in the same group,the D-D and FIB levels in the IPC group were lower than those in the routine group,the PT,APTT,and TT were longer than those in the routine group,the differences were statistically significant(P<0.05).After the treatment,the visual analogue scale(VAS)score and swelling degree of the two groups were lower than themselves before the treatment,the foregoing indexes in the IPC group were lower than those in the routine group,the differences were statistically significant(P<0.05).The incidence of VTE in the IPC group was
作者
张美颖
张欢
张雪
赵春晓
Zhang Meiying;Zhang Huan;Zhang Xue;Zhao Chunxiao(Department of Special Medical,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of ICU,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《血管与腔内血管外科杂志》
2022年第10期1196-1200,共5页
Journal of Vascular and Endovascular Surgery
