[1]孔刚,马卫华,张树栋.单侧与双侧使用间歇充气加压在预防髋膝置换术后DVT中的效果比较[J].中华老年骨科与康复电子杂志,2019,(01):13-18.[doi:10.3877/cma.j.issn.2096-0263.2019.01.004]
　Kong Gang,Ma Weihua,Zhang Shudong.Comparison of the effect of IPC on non operative side and bilateral sides in DVT prevention after hip and knee replacement[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(01):13-18.[doi:10.3877/cma.j.issn.2096-0263.2019.01.004]
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单侧与双侧使用间歇充气加压在预防髋膝置换术后DVT中的效果比较()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年01期
页码:
13-18
栏目:
髋部骨折
出版日期:
2019-02-05

文章信息/Info

Title:
Comparison of the effect of IPC on non operative side and bilateral sides in DVT prevention after hip and knee replacement
作者:
孔刚; 马卫华; 张树栋
264001 烟台市烟台山医院骨关节科
Author(s):
Kong Gang;  Ma Weihua;  Zhang Shudong
Department of Orthopaedics, Yantaishan Hospital, Yantai 264001, China
关键词:
静脉血栓形成;  间歇充气加压装置;  关节成形术; 置换;  临床试验
Keywords:
Vein thrombosis;  Intermittent pneumatic compression devices;  Arthroplasty;  replacement;  Clinical trials
DOI:
10.3877/cma.j.issn.2096-0263.2019.01.004
文献标志码:
A
摘要:
目的 探讨间歇充气加压（IPC）非手术侧使用，在髋膝关节置换术后下肢深静脉血栓（DVT）预防中的效果和安全性。方法 前瞻性收集2017年4月至2017年9月烟台市烟台山医院拟行髋、膝关节置换术且符合纳入及排除标准的患者172例，采用随机数字表法将患者随机分为试验组和对照组，所有患者均于麻醉后手术开始前开始行非术侧IPC治疗，术后给予利伐沙班抗凝预防DVT，试验组术后继续行持续性非术侧IPC预防DVT，共85例；对照组术后行持续性双侧IPC预防DVT，共87例。术后3 d后改为1 h，2次/日。术后3 d、7～10 d行双下肢超声检查监测DVT发生情况。结果 患者术后常规继续住院7～10 d，故术后患者无脱落，随访率100%。随访时间为7～10 d，平均（8.3±1.3）d，试验组术后3 d发生血栓11例，占12.9%，均为肌间静脉血栓；对照组术后3 d发生血栓8例，占9.2%，1例腘静脉血栓，2例胫腓静脉血栓，余为肌间静脉血栓；术后3 d两组膝关节置换患者、髋关节置换患者及总的DVT发生率均无统计学差异。术后7～10 d试验组新增血栓5例，占6.8%，对照组新增血栓4例，占比5.1%，两组术后7～10 d膝置换患者、髋置换患者及总DVT发生率均无统计学差异。结论 IPC非手术侧使用在预防髋膝置换术后下肢DVT发生中可达到与IPC双侧同时使用相同的预防效果，安全性更高。
Abstract:
Objective To investigate the effectiveness and safety of nonoperative side intermittent pneumatic compression (IPC) in hip and knee arthroplasty for the prevention of deep venous thrombosis. Methods From April 2017 to September 2017, patients who admitted to our hospital and scheduled for hip arthroplasty or knee arthroplasty were conducted prospectively according to the inclusion and exclusion criteria, 172 selected patients were randomly divided into experimental group and control group. All patients underwent non-operative side IPC at the time of surgery, and took postoperative rivaroxaban anticoagulation to prevent DVT. There were 85 patients in experimental group with persistent non-operative side IPC postoperatively; whereas there were 87 patients as control with persistent bilateral IPC postoperatively. Initially, IPC was given 1 h, twice a day for 3 days. Ultrasonic detection was conducted for DVT of both lower extremities on 2 time points, i.e. 3d and 7-10 d following surgery. Results Patient were hospitalized for 7-10 days after surgery, no patient fall off after operation. The follow-up time was 7-10 days, the average time was (8.3±1.3)d and the was 100%. In the experimental group, 11 patients had thrombosis at 3rd days after operation, accounting for 12.9%, all of which were intramuscular venous thrombosis. In the control group, 8 patients had thrombosis 3 days after operation, accounting for 9.2%, 1 case of iliac vein thrombosis and 2 cases of iliac vein thrombosis. The rest were intramuscular venous thrombosis. there was no significant difference in the DVT incidence of knee replacement, hip replacement and total DVT number between two groups. In the experimental group, 5 cases developed new thrombosis in the experimental group, accounting for 6.8%, and 4 cases developed new thrombosis in the control group, accounting for 5.1%. There was no statistically significant difference in the DVT incidence of the knee replacement patients, hip replacement patients and total DVT number 7-10 days after operation between two groups. Conclusion The non-surgical side of IPC can achieve the same preventive effect as the simultaneous use of IPC on both sides in the prevention of deep venous thrombosis after hip and knee replacement, and it is safer.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：烟台市科技局立项课题（2015WS056）
更新日期/Last Update: 2019-02-25