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不同时间长度应用SCD感应抗血栓泵的临床观察

李霞   

  1. 河北省承德医学院附属医院骨外三科
  • 收稿日期:2010-06-29 修回日期:2010-09-13 出版日期:2011-02-15 发布日期:2011-02-15
  • 通讯作者: 李霞

The efficacy of different therapy time of sequential compression devices for proventing deep venous thrombosis following replacement

  • Received:2010-06-29 Revised:2010-09-13 Published:2011-02-15 Online:2011-02-15

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摘要： 目的 比较人工关节置换术后采取不同的时间长度应用SCD感应抗血栓泵预防下肢深静脉血栓形成的效果观察。方法 2007年12月至2009年12月，111例患者随机分成2组，对照组55例，实验组56例，术后立即开始使用SCD感应抗血栓泵，对照组第一天持续应用，从第二天之后每4h使用一次，每次持续1h；实验组术后每6h使用一次，每次持续1h。两组患者均在术前及术后7~10天行彩色多普勒超声检查。结果 对照组DVT发生率为3.64%，其中THR术后DVT发生率为3.85%，TKR术后DVT发生率为3.45%；实验组DVT发生率为5.36%，其中THR术后DVT发生率为3.85%，TKR术后DVT发生率为6.67%，两组下肢深静脉血栓形成发生率的差异无统计学意义（x2=0.191 p>0.05）。另外，术后第1天对照组TKR患者患肢大片皮下瘀斑发生率为37.93%，实验组TKR患者患肢大片皮下瘀斑发生率为10.00%，且相对面积小于对照组TKR患者，两组TKR患者皮下瘀斑发生率的差异有统计学意义（x2=6.356 p<0.05）。结论 使用SCD感应抗血栓泵预防人工关节置换术后下肢深静脉血栓形成，每6h一次，每次1h就能达到预期效果，并非时间越长效果越好。

关键词: 深静脉血栓形成, 人工关节置换, 抗血栓泵

Abstract: Objective Assessing the effectiveness of different therapy time of sequential compression devices (SCD) for proventing deep venous thrombosis following arthroplasty Methods 111 patients undergoing primary arthroplasty from December 2007 to December 2009 were divided into two groups randomly. In the observation group, 56 patients received SCD after operation, therapy time one hour, intermission 6 hour. In the control group, 55 patients received SCD after operation, continous therapy for 24 hour. From the Second day, therapy time one hour, intermission 4 hour. DVT formation of two groups was diagnosed with colour ultrasonography at 7~10 days post-operation. Results In the observation group, three cases of DVT(5.36%) were found, one case in total hip replacement ( THR), two cases in total knee replacement (TKR). In the control group, two cases of DVT(3.64%) were found, one case in THR, one cases in TKR. The incidence of DVT in two groups had no difference (χ2=0.109, P>0.05). In the observation group, 11cases of cutaneous ecchymosis of surgical leg(37.93%) were found on the first day after surgery. In the control group, 3 cases of cutaneous ecchymosis of surgical leg(10.00%) were found on the first day after surgery. Comparing the incidence of cutaneous ecchymosis , the observation group was higher than control group (χ2=6.365, P<0.05).Conclusion Different therapy time of SCD had same effectiveness for proventing deep venous thrombosis following arthroplasty. The therapy of intermission 6 hour reduced incidence of cutaneous ecchymosis.

Key words: Deep venous thrombosis, Arthroplasty, Sequential compression devices