摘要
目的 探讨间歇性气压(IAP)治疗对重症医学科(ICU)患者下肢深静脉血栓(DVT)的预防价值。方法 收集2020年5月至2022年3月首都医科大学附属北京世纪坛医院收治的122例ICU患者的临床资料,根据是否接受IAP治疗将其分为治疗组(n=53,接受IAP治疗)和对照组(n=69,未接受IAP治疗)。比较两组患者ICU住院时间及其下肢DVT发生率、复查时间,观察两组患者入院时、复查时的D-二聚体(D-D)水平、凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、国际标准化比值(INR)],统计两组患者住院期间的并发症发生情况。结果 两组患者ICU住院时间、复查时间比较,差异均无统计学意义(P>0.05)。ICU住院期间,治疗组患者下肢DVT发生率为5.7%(3/53),低于对照组患者的18.8%(13/69),差异有统计学意义(P<0.05)。复查时,两组患者各项凝血功能指标均低于本组入院时,D-D水平均高于本组入院时,治疗组患者FIB、D-D水平均低于对照组患者,差异均有统计学意义(P<0.05)。复查时,两组患者PT、TT、APTT、INR比较,差异均无统计学意义(P>0.05)。治疗组患者均未发生IAP治疗相关并发症,两组患者呼吸机相关性肺炎、谵妄、出血发生率比较,差异均无统计学意义(P>0.05)。结论 IAP治疗可降低重症患者ICU住院期间下肢DVT发生率,不影响患者的凝血功能,不增加患者的并发症发生率,安全、有效,值得临床推广。
Objective To observe the preventive value of intermittent air pressure(IAP) therapy for lower extremity deep vein thrombosis(DVT) in intensive care unit(ICU) patients. Method The clinical data of 122 patients admitted in Beijing Shijitan Hospital, Capital Medical University from May 2020 to March 2022 were selected, they were divided into the treatment group(n=53, received IAP therapy) and control group(n=69, no IAP therapy) according to IAP treatment. The ICU stay time, incidence of lower extremity DVT, revisit time of two groups were compared. The D-dimer(D-D) levels, coagulation function indexes [thrombin time(TT), prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB) and international normalized ratio(INR)] during admission time and revisit time of two groups were observed. The incidence of complication during hospital stay were compared between the two groups.Result There were no statistical differences in the ICU stay time and revisit time between the two groups(P>0.05). The incidence rate of lower extremity DVT in the treatment group during hospitalization in ICU was 5.7%(3/53), lower than 18.8%(13/69) of control group, the difference was statistically significant(P<0.05). During revisit time, all coagulation function indexes of patients in the two groups were lower than those of patients in their group at the time of admission,the levels of D-D were higher than that of patients in their group at the time of admission, the levels of FIB and D-D in the treatment group were lower than that of patients in the control group, the differences were statistically significant(P<0.05).There were no significant differences of PT, TT, APTT and INR between the two groups during revisit time(P>0.05). There were no complications related to IAP treatment in the treatment group, there were no significant differences for the incidence of ventilator-associated pneumonia, delirium and bleeding(P>0.05). Conclusion IAP therapy can decrease the incidence of lower extremity DVT during ICU stay in crit
作者
刘薇
李曼
武洋
牛鹿原
Liu Wei;Li Man;Wu Yang;Niu Luyuan(Department of Surgical Intensive Care Unit,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Vascular Surgery,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12期1458-1461,1488,共5页
Journal of Vascular and Endovascular Surgery
关键词
深静脉血栓
重症
间歇性气压
deep vein thrombosis
critically ill
intermittent air pressure
