CAJ | 학술논문

目的探讨急性下肢深静脉血栓形成静脉溶栓治疗的最佳给药方式.方法将270例急性下肢深静脉血栓患者随机分为三组, A组：上肢周围静脉给药组,90例经上肢周围静脉途径给药,给予NS250ml+纤溶酶300u,输液速度45~50滴/每分,2小时内输完；B组：患肢足背静脉快速给药组,90例经患肢足背静脉给药,在踝关节上5 cm处阻断浅静脉后,以45~50滴/每分输入,2小时内输完；C组：患肢足背静脉匀速给药组,90例经患肢足背静脉给药,在踝关节上5 cm处阻断浅静脉后匀速泵入,12小时输完.三组患者均使用NS250ml+纤溶酶300u,均配合在另一侧上肢周围静脉输入血栓通、低分子右旋糖酐,皮下注射低分子肝素等综合治疗.用药一周后比较3组患者患肢消肿率及溶栓率.结果 B、C两组消肿率及溶栓率优于A组,P<0.05；阻断浅静脉后的患肢给药方式效果更为迅速；给药速度对治疗效果影响不大,B组与C组消肿率及溶栓率无差异,P>0.05.结论局部加压溶栓和快速给药治疗下肢深静脉血栓形成是一种有效的方法,可减轻病人由于输液时间过长带来的不适感,减轻护士工作量.
목적탐토급성하지심정맥혈전형성정맥용전치료적최가급약방식.방법장270례급성하지심정맥혈전환자수궤분위삼조, A조：상지주위정맥급약조,90례경상지주위정맥도경급약,급여NS250ml+섬용매300u,수액속도45~50적/매분,2소시내수완；B조：환지족배정맥쾌속급약조,90례경환지족배정맥급약,재과관절상5 cm처조단천정맥후,이45~50적/매분수입,2소시내수완；C조：환지족배정맥균속급약조,90례경환지족배정맥급약,재과관절상5 cm처조단천정맥후균속빙입,12소시수완.삼조환자균사용NS250ml+섬용매300u,균배합재령일측상지주위정맥수입혈전통、저분자우선당항,피하주사저분자간소등종합치료.용약일주후비교3조환자환지소종솔급용전솔.결과 B、C량조소종솔급용전솔우우A조,P<0.05；조단천정맥후적환지급약방식효과경위신속；급약속도대치료효과영향불대,B조여C조소종솔급용전솔무차이,P>0.05.결론국부가압용전화쾌속급약치료하지심정맥혈전형성시일충유효적방법,가감경병인유우수액시간과장대래적불괄감,감경호사공작량.
Objective To explore the best way of drug application for acute deep venous thrombus. Methods 270 patients with acute deep venous thrombus were randomized into three groups. Group 1 had 90 patients receiving drug from upper limbs 45-50 drops/min within 2 hours. Group 2 received fast drug infusion of the affected leg while blocking the superficial veins 5cm above the ankle at the speed of 45-50drops/min. Group 3 with 90 patients received well-distributed drug infusion for 12 hours blocking the superficial veins 5cm above the ankle. All three groups received with NS250ml+300u plasmin and receiving dextran-40 and heparin at the same time. Results Group 2 and 3 had better fibrolytic effect than group 1. Superficial vein blocking had faster effect that other approaches but the speed of drug infusion had little effect for therapeutic effect. Conclusion Local fibrolytic compression and fast drug infusion would be effective for deep vein thrombi and reduce patient’s sufferings and working load for nurses.