CAJ | 학술논문

目的探讨间歇充气加压治疗(IPC)对内科重症患者静脉血栓栓寒症(VTE)的预防作用。方法采用前瞻性随机对照临床试验，将2008年6月至2010年6月收入重症监护病房(ICU)未接受抗凝治疗的162例重症患者按随机数字表法分配到IPC组和对照组。IPC组从患者入ICU当日直到离开ICU给予IPC预防VTE;对照组不予任何措施预防VTE;以28 d为观察期，比较观察期内两组患者VTE[包括深静脉血栓形成(DVT)和肺栓塞(PE)]发生率、机械通气时间、ICU住院时间、非心源性猝死发生率、ICU病死率及IPC预防VTE的不良反应。结果在观察期内，IPC组和对照组DVT发生率分别为3.80％(3/79)和19.28％(16/83)，PE发生率分别为0(0/79)和9.64％(8/83)，非心源性猝死发生率分别为1.26％(1/79)和7.23％(6/83)，两组比较差异均有统计学意义(均P＜0.01)IPC组机械通气时间（d：8±6比9±8）、ICU住院时间（d：9±7比10±7）、ICU 28 d病死率(24.05％比31.32％)均低于对照组，但差异无统计学意义(均P＞0.05)。IPC预防VTE过程中没有出现相关不良反应。结论 IPC是预防内科重症患者发生VTE的一种安全有效的措施，IPC可以降低内科重症患者非心源性猝死发生率。
목적 탐토간헐충기가압치료(IPC)대내과중증환자정맥혈전전한증(VTE)적예방작용。방법 채용전첨성수궤대조림상시험，장2008년6월지2010년6월수입중증감호병방(ICU)미접수항응치료적162례중증환자안수궤수자표법분배도IPC조화대조조。IPC조종환자입ICU당일직도리개ICU급여IPC예방VTE;대조조불여임하조시예방VTE;이28 d위관찰기，비교관찰기내량조환자VTE[포괄심정맥혈전형성(DVT)화폐전새(PE)]발생솔、궤계통기시간、ICU주원시간、비심원성졸사발생솔、ICU병사솔급IPC예방VTE적불량반응。결과 재관찰기내，IPC조화대조조DVT발생솔분별위3.80％(3/79)화19.28％(16/83)，PE발생솔분별위0(0/79)화9.64％(8/83)，비심원성졸사발생솔분별위1.26％(1/79)화7.23％(6/83)，량조비교차이균유통계학의의(균P＜0.01)IPC조궤계통기시간（d：8±6비9±8）、ICU주원시간（d：9±7비10±7）、ICU 28 d병사솔(24.05％비31.32％)균저우대조조，단차이무통계학의의(균P＞0.05)。IPC예방VTE과정중몰유출현상관불량반응。결론 IPC시예방내과중증환자발생VTE적일충안전유효적조시，IPC가이강저내과중증환자비심원성졸사발생솔。
Objective To evaluate the efficacy of intermittent pneumatic compression (IPC) in the prevention of venous thromboembolism (VTE) in medical critically ill patients. Methods A prospective,randomized, controlled study was conducted. One hundred and sixty-two medical critically ill patients were randomly assigned to IPC group and control group by random number table after admitted to intensive care unit (ICU) from June 2008 to June 2010. Patients under anticoagulation medicine therapy were excluded.Patients in the IPC group were treated with IPC to prevent VTE after ICU admission. No measures were taken to prevent VTE in the control group. The rate of VTE [deep vein thrombosis (DVT) and pulmonary embolism (PE)], duration of mechanical ventilation (MV), the length of stay in ICU, rate of non-sudden cardiac death and ICU mortality rate and related side-effects of IPC were compared during the subsequent 28 days between two groups. Results Compared with control group, IPC group was shown to have a significantly lower rate of DVT [3.80％ (3/79) vs. 19.28％ (16/83), P＜0.01], lower rate of PE [0 (0/79) vs. 9.64％ (8/83), P＜0. 01] and lower rate of non-sudden cardiac death [1.26％ (1/79) vs.7. 23 ％ (6/83), P＜0. 01]. Compared with control group, duration of MV (days : 8 ± 6 vs. 9 ± 8) and length of stay in ICU (days: 9±7 vs. 10±7) were shorter, and the ICU mortality rate of 28 days (24.05％ vs.31.32％) was lower in the IPC group, but they were not statistically significant (all P＞0. 05). No related side-effects were found in the IPC group. Conclusion IPC can prevent VTE, and lower the rate of non-sudden cardiac death, and it is safe in medical critically ill patients.