间歇性充气压力泵在髋关节置换术后预防下肢深静脉血栓形成的作用

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摘要目的评估间歇性充气压力泵(intermittent pneumatic compression，IPC)在髋关节置换术后预防下肢深静脉血栓(deep vein thrombosis，DVT)的效果。方法 2013年1月至2014年12月，髋关节置换术后应用低剂量阿司匹林抗凝治疗的患者被纳入对照组。2015年1月至2016年12月，髋关节置换术后应用IPC与低剂量阿司匹林治疗的患者纳入IPC组。回顾性的收集和分析两组患者的年龄、性别、身体质量指数、手术时间、住院时间和原发疾病等资料，共有778例患者纳入了本研究，其中对照组286例，男157例，女129例；平均年龄(61.21±7.92)岁。IPC组492例，男268例，女224例；平均年龄(60.48±8.04)岁。通过比较两组患者DVT发病率和发病部位来评估IPC的预防效果，分析危险因素如年龄、性别、身体质量指数、手术时间和住院时间与DVT的相关性，同时分析IPC应用相关的并发症。结果两组的平均随访时间分别为(11.75±6.44)个月(对照组)和(11.02±6.69)个月(IPC组)，差异无统计学意义(P＝0.134)。对照组的平均住院时间要明显长于IPC组(P＜0.001)。对照组和IPC组分别有12例和7例患者出现了DVT症状，IPC组1.4%的发病率要显著低于对照组的4.2%，P＜0.05。IPC组患者均没有观察到IPC应用相关的并发症。静脉血栓栓塞的患者比无血栓患者年龄更大、住院时间更长(P＜0.05)。结论本研究结果显示IPC结合低剂量阿司匹林是预防髋关节置换术后静脉血栓形成的一种安全有效的方法。

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关键词 ：深静脉血栓, 预防, 间歇性充气压力泵, 髋关节置换

Abstract：Objective To evaluate the effectiveness of intermittent pneumatic compression (IPC) in the prevention of DVT after hip arthroplasty.Methods From Jan.2013 to Dec.2014，consecutive patients treated with low dose Aspirin after hip arthroplasty were collected as thecontrol group.From Jan.2015 to Dec.2016，patients received both IPC and low dose Aspirin were included in the IPC group.We retrospectively collected and analyzed the demographic data such as age，gender，body mass index(BMI)，time of operation，hospitalization period，and underlying disease for hip arthroplasty.A total of 778 patients were collected in this retrospective study.Among them，thecontrol group had 286 patients(157 males，129 females).The average age was(61.21±7.92).The IPC group had 492 patients(268 males，224 females).The average age was(60.48±8.04).The effectiveness of IPC in the prevention of DVT was evaluated through the comparison of DVT incidences between the two groups.Risk factors affecting the development of DVT were determined from age，gender，BMI，time of operation，and hospitalization period.Any complications related to the application of IPC would be collected as well.Results The mean follow-up time were(11.75±6.44)months and(11.02±6.69)months of the control group and the IPC group，respectively(P＝0.134).There were no significant differences in most demographic data between the two groups.However，hospitalization period of the control group was significantly longer than that of the IPC group (P＜0.001).There were 12 patients and 7 patients developing DVT in thecontrol group and the IPC group，respectively.The IPC group (1.4%) had a remarkably lower incidence of DVT than the control group did(4.2%)，P＜0.05.There was no IPC relating complication observed in the IPC group.The patients having DVT were older and stayed longer inthehospital than those not affected by DVT(P＜0.05).Conclusion The results of the current study suggest that IPC might be an effective and safe option for the prevention of DVT after hip arthroplasty.

Key words： deep vein thrombosis prevention intermittent pneumatic compression hip arthroplasty

通讯作者: 李浩鹏

作者简介: 李珂(1975－ )，女，主管护师，西安交通大学第二附属医院骨二科，710006。

引用本文:

李珂，李京，孙宏，陈静，郝丹丹，李浩鹏 *. 间歇性充气压力泵在髋关节置换术后预防下肢深静脉血栓形成的作用[J]. 实用骨科杂志, 2021, 27(4): 306-309.
Li Ke，Li Jing，Sun Hong，et al. Evaluating the Effectiveness of Intermittent Pneumatic Compression in the Prevention of Deep Vein Thrombosis After Hip Arthroplasty. sygkzz, 2021, 27(4): 306-309.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I4/306

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