中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
9期
737-739
,共3页
黄志军%曲乐丰%景在平%刘傲飞%袁良喜
黃誌軍%麯樂豐%景在平%劉傲飛%袁良喜
황지군%곡악봉%경재평%류오비%원량희
静脉血栓形成%病例对照研究%早日下床活动%卧床休息
靜脈血栓形成%病例對照研究%早日下床活動%臥床休息
정맥혈전형성%병례대조연구%조일하상활동%와상휴식
Venous thrombosis%Case-control studies%Early ambulation%Bed rest
目的 比较急性下肢深静脉血栓形成(deep venous thrombosis,DVT)早期下床活动与卧床治疗疗效及并发肺梗死风险的差异.方法 将2008年02月至2009年03月收治的40例急性原发性DVT患者随机分为对照组和实验组,每组20例,均为发病7 d内入院治疗.对照组予卧床、弹力袜支持及患肢抬高治疗7～10 d;实验组予早期(入院后1～2 d)弹力袜支持下床行走(600～1200)m/d治疗7～10 d,两组均予正规抗凝及消肿辅助治疗,出院后继续抗凝治疗至少6个月.观察比较胀痛缓解[视觉模拟评分法,(visual analogue scale,VAS)]和患肢肿胀消退情况(患肢大腿周径变化值),以及3个月中两组患者肺梗死的累计发生率.结果 两组患者症状体征均改善,对照组胀痛VAS值第5天(58±13)mm才下降到实验组第3天VAS值(58±8)mm的水平.治疗7 d后患肢大腿周径变化值的平均减小值,实验组为(2.9±0.9)cm,好于对照组的(1.5±0.8)cm,差异有统计学意义(t=3.335,P＜0.05).两组3个月内均未发生症状性肺梗死.结论 初步研究结果提示急性下肢深静脉血栓形成早期下床活动治疗较卧床治疗患肢疼痛和肿胀的症状改善更明显,更快,生活质量明显提高,并没有增加肺梗死的发生率.
目的 比較急性下肢深靜脈血栓形成(deep venous thrombosis,DVT)早期下床活動與臥床治療療效及併髮肺梗死風險的差異.方法 將2008年02月至2009年03月收治的40例急性原髮性DVT患者隨機分為對照組和實驗組,每組20例,均為髮病7 d內入院治療.對照組予臥床、彈力襪支持及患肢抬高治療7～10 d;實驗組予早期(入院後1～2 d)彈力襪支持下床行走(600～1200)m/d治療7～10 d,兩組均予正規抗凝及消腫輔助治療,齣院後繼續抗凝治療至少6箇月.觀察比較脹痛緩解[視覺模擬評分法,(visual analogue scale,VAS)]和患肢腫脹消退情況(患肢大腿週徑變化值),以及3箇月中兩組患者肺梗死的纍計髮生率.結果 兩組患者癥狀體徵均改善,對照組脹痛VAS值第5天(58±13)mm纔下降到實驗組第3天VAS值(58±8)mm的水平.治療7 d後患肢大腿週徑變化值的平均減小值,實驗組為(2.9±0.9)cm,好于對照組的(1.5±0.8)cm,差異有統計學意義(t=3.335,P＜0.05).兩組3箇月內均未髮生癥狀性肺梗死.結論 初步研究結果提示急性下肢深靜脈血栓形成早期下床活動治療較臥床治療患肢疼痛和腫脹的癥狀改善更明顯,更快,生活質量明顯提高,併沒有增加肺梗死的髮生率.
목적 비교급성하지심정맥혈전형성(deep venous thrombosis,DVT)조기하상활동여와상치료료효급병발폐경사풍험적차이.방법 장2008년02월지2009년03월수치적40례급성원발성DVT환자수궤분위대조조화실험조,매조20례,균위발병7 d내입원치료.대조조여와상、탄력말지지급환지태고치료7～10 d;실험조여조기(입원후1～2 d)탄력말지지하상행주(600～1200)m/d치료7～10 d,량조균여정규항응급소종보조치료,출원후계속항응치료지소6개월.관찰비교창통완해[시각모의평분법,(visual analogue scale,VAS)]화환지종창소퇴정황(환지대퇴주경변화치),이급3개월중량조환자폐경사적루계발생솔.결과 량조환자증상체정균개선,대조조창통VAS치제5천(58±13)mm재하강도실험조제3천VAS치(58±8)mm적수평.치료7 d후환지대퇴주경변화치적평균감소치,실험조위(2.9±0.9)cm,호우대조조적(1.5±0.8)cm,차이유통계학의의(t=3.335,P＜0.05).량조3개월내균미발생증상성폐경사.결론 초보연구결과제시급성하지심정맥혈전형성조기하상활동치료교와상치료환지동통화종창적증상개선경명현,경쾌,생활질량명현제고,병몰유증가폐경사적발생솔.
Objective To evaluate the benefits and the risk of pulmonary embolism between walking exercises and bed rest in the acute stage of deep venous thrombosis (DVT). Methods From February 2008 to March 2009,40 acute primary DVT patients were arbitrarily randomized into controlled group and experimental group,with 20 cases in each group,who were hospitalized within seven days of onset.Patients in controlled group underwent bed rest for 7-10 days,wearing elastic stockings.While patients in experimental group were early (1-2 days after admission) off bed walking about 600-1200 m every day with elastic stockings for 7-10 days.During the process patients in both group received regular anticoagulation treatment,and continued warfarin anticoagulation therapy after out of hospital for at least 6 months.The clinical characteristics of the two groups were comparable.Primary end points were the reduction of pain assessed daily with the Visual Analogue Scale (VAS),the reduction of leg circumference at thigh,and cumulative pulmonary embolism incidences of two groups in three months. Results Symptoms in all patients of the two groups were improved,but the pain level showed a statistically significant reduction starting after the third day(58 ±8) mm in the experiment group and after the fifth day (58 ± 13) mm in the controlled group.The leg circumferences of the two groups after 7 days were statistically significantly different (P ＜ 0.05),the cumulative pulmonary embolism incidences of the two groups for 3 months were not statistically significantly different. Conclusion Mobile patients with acute DVT should be encouraged to walk with medical compression stockings.The rate of resolution of pain and swelling is significantly faster when the patient ambulates with compression.The quality of life significantly improved.The risk of pulmonary embolism does not significantly increase by this approach.
