摘要
目的比较全膝关节置换术(TKR)后多模式防治策略与传统防治措施预防术后深静脉血栓形成(DVT)的效果,探讨TKR预防DVT的有效方法。方法收集2011年7月至2013年6月该院行TKR患者289例,2012年7月前的137例患者为A组,术后采用传统的DVT预防措施;2012年7月以后的152例患者为B组,术后固定采用序贯、交叉的联用低分子肝素、间歇式充气压力治疗及持续股神经阻滞镇痛的多模式预防策略。比较两组患者术后DVT发生率、分布部位以及两组患者年龄、性别构成、体质量指数、疾病种类、手术时间、手术出血量、术中输血、输液量和术后引流量。结果 B组患者术后DVT发生率明显低于A组,差异有统计学意义(P<0.05),两组患者中发生的DVT在近端、远端静脉分布构成比方面差异无统计学意义(P>0.05)。结论与传统防治措施相比,TKR后采用序贯、交叉的联用低分子肝素、间歇式充气压力治疗及持续股神经阻滞镇痛的多模式预防策略,可以更加有效地预防术后DVT的发生。
Objective To explore the more effective measures for the prevention of deep vein thrombosis （DVT ） by comparing the different efficacy between the multimodal strategy and liberal measures .Methods From July 2011 to June 2013 ,medical records of 289 patients who had accepted total knee replacement （TKR） were collected .Patients were divided into two groups according to whether exploring to the multimodal strategy or liberal measures after TKR .The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,intermittent pneumatic compression ,and postoperative continues femoral nerve block analgesia .Patients in group A were treated during July 2011 to June 2012 ,and accepted liberal measures for the prevention of DVT .Patients in group B were treated after June 2012 ,and accepted multimodal strategy .The data of each group were collected for statistical analysis on the following aspects ：DVT occurrence rate ,DVT distribution ,age ,gender ,body mass index ,disease ,operation duration ,volume of blood loss and transfusion during operation phase ,drainage volume after TKR .Results The DVT occurrence rate of patients in group B were significantly lower than that of patients in group A （P0 .05） .Conclusion The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,postoperative low molecular weight heparin ,and postoperative continues femoral nerve block analgesia is more effective than liberal measures for the prevention of DVT .
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第6期661-662,665,共3页
Chongqing medicine
基金
重庆市科委科技攻关项目(cstc2012gg-yyjsl0053)
重庆市卫生局面上项目(2011-2-006)
国家临床重点专科建设项目(财社[2011]170号)
关键词
全膝关节置换术
深静脉血栓
多模式
临床研究
total knee replacement
deep vein thrombosis
multimodal strategy
retrospective clinical study
