空气波压力治疗对脑卒中偏瘫患者患侧下肢深静脉血流动力学的影响
摘要
目的探讨空气波压力疗法对脑卒中偏瘫患者患侧下肢深静脉血流动力学的影响。方法选取2016年5月至2017年10月合肥市第二人民医院康复医学科住院的脑卒中偏瘫患者30例为研究对象,对单次治疗、多次治疗2种治疗结果进行测量:单次治疗使用模式A、压力80 mm Hg的空气波压力治疗患侧下肢20 min,利用彩色多普勒超声观察不同时间段(治疗前,治疗后即刻、20、40、60分钟)患侧下肢股总静脉血流平均速度(Vm)、血流峰速度(Vmax)、血流量(BF)变化情况;多次治疗使用模式A、压力80 mm Hg空气波压力治疗患侧下肢,每次20 min、2次/天,反复治疗时间大致为20 d,静息状态下,利用彩色多普勒超声观察患侧下肢股总静脉的上述血流动力学指标变化情况。利用单因素方差分析等对检测结果进行统计学分析。结果单因素方差分析发现,单次治疗后Vm、Vmax和BF在不同时间点间的测量值差异有统计学意义(P <0. 05)。两两比较发现,治疗后血流动力学各指标在即刻、20分钟、40分钟较治疗前增加,差异有统计学意义(P <0. 05),而治疗后60分钟值相比治疗前,差异无统计学意义(P>0. 05)。治疗20天后,患者的Vmax值明显增加,与治疗前比较,差异具有统计学意义(P <0. 05)。结论对于单次的空气波压力治疗来说,治疗效果大约可持续到治疗后1小时,20天多次的空气波压力治疗可促进脑卒中偏瘫患者患侧下肢深静脉血液回流。
引文
[1]程万春,陈璇.脑卒中患者早期下肢深静脉血栓形成的研究[J].国际神经病学神经外科学杂志,2014,41(3):227-230.
[2]吴兆苏,姚崇华,赵冬.我国人群脑卒中发病率、死亡率的流行病学研究[J].中华流行病学杂志,2003,24(3):236-239.
[3]中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,36(2):65-71.
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[5]王洋,徐亮.空气波压力治疗仪对直肠癌术后凝血功能及对下肢深静脉血栓(DVT)的预防作用[J].中国医药指南,2015,13(36):111-112.
[6]全国第四届脑血管病会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[7]章稼,王晓臣.运动治疗技术[M].2版.北京:人民卫生出版社,2016:329-387.
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[9]高立强,陈伟.78例急性脑卒中合并下肢静脉血栓回顾性研究[J].临床荟萃,2015,30(2):216-218.
[10]DELIS K T,LABROPOULOS N,NICOLAIDES A N,et al.Effect of intermittent pneumatic foot compression on popliteal artery haemodynamics[J].Eur J Vasc Endovasc Surg,2000,19(3):270-277.
[11]YAMASHITA K,YOKOYAMA T,KITAOKA N,et al.Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression[J].J Clin Anesth,2005,17(2):102-105.
[12]凌康,夏清,杨晓,等.空气波压力治疗仪对健康者下肢深静脉血流动力学的影响[J].安徽医学,2017,38(2):136-139.
[13]PROTZ K,HEYER K,DORLER M,et al.Compression therapy:scientific background and practical applications[J].J Dtsch Dermatol Ges,2014,12(9):794-801.
[14]PAVON J M,ADAM S S,RAZOUKI Z A,Effectiveness of intermittent pneumatic compression devices for venous thromboembolism prophylaxis in high-risk surgical patients:a systematic review[J].J Arthroplasty,2016,31(2):524-532.
[15]丁雪芹,于守梅,姜霞霞,等.动静脉足泵对腰椎术后患者下肢深静脉血栓的预防效果[J].中国实用护理杂志,2017,33(2):1952-1955.
[16]FLAM E,BERRY S,COYLE A,et al.Blood-flow augmentation of intermittent pneumatic compression systems used for prevention of deep vein thrombosis prior to surgey[J].AM J Surg,1996,171(7):312-315.
[17]CLOTS(Clots in Legs Or s Tockings after Stroke)Trials Collaboration.Effect of intermittent pneumatic compression on disability,living circumstances,quality of life,and hospital costs after stroke:secondary analyses from CLOTS 3,a randomised trial[J].Lancet Neurol,2014,13(12):1186-1192.
[18]DENNIS M,SANDERCOCK P,GRAHAM C,et al.The Clots in Legs Or s Tockings after Stroke(CLOTS)3 trial:a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of poststroke deep vein thrombosis and to estimate its cost-effectiveness[J].Health Technol Assess,2015,19(76):1-90.
[19]HANKEY G J.Intermittent pneumatic compression after stroke[J].Lancet Neurol,2014,13(12):1163-1165.
[2]吴兆苏,姚崇华,赵冬.我国人群脑卒中发病率、死亡率的流行病学研究[J].中华流行病学杂志,2003,24(3):236-239.
[3]中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,36(2):65-71.
[4]ASOPA V,COBAIN W,MARTIN D,et al.Staged venous thromboemolic events prophylaxis with low-molecularweight heparin followed by aspirin is safe andeffective after arthroplasty[J].ANZ J Surg,2015,85(9):652-657.
[5]王洋,徐亮.空气波压力治疗仪对直肠癌术后凝血功能及对下肢深静脉血栓(DVT)的预防作用[J].中国医药指南,2015,13(36):111-112.
[6]全国第四届脑血管病会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[7]章稼,王晓臣.运动治疗技术[M].2版.北京:人民卫生出版社,2016:329-387.
[8]苏里亚,徐光,彭禹.老年卧床患者下肢深静脉血流动力学改变与血栓形成的关系[J].首都医科大学学报,2009,30(3):396-398.
[9]高立强,陈伟.78例急性脑卒中合并下肢静脉血栓回顾性研究[J].临床荟萃,2015,30(2):216-218.
[10]DELIS K T,LABROPOULOS N,NICOLAIDES A N,et al.Effect of intermittent pneumatic foot compression on popliteal artery haemodynamics[J].Eur J Vasc Endovasc Surg,2000,19(3):270-277.
[11]YAMASHITA K,YOKOYAMA T,KITAOKA N,et al.Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression[J].J Clin Anesth,2005,17(2):102-105.
[12]凌康,夏清,杨晓,等.空气波压力治疗仪对健康者下肢深静脉血流动力学的影响[J].安徽医学,2017,38(2):136-139.
[13]PROTZ K,HEYER K,DORLER M,et al.Compression therapy:scientific background and practical applications[J].J Dtsch Dermatol Ges,2014,12(9):794-801.
[14]PAVON J M,ADAM S S,RAZOUKI Z A,Effectiveness of intermittent pneumatic compression devices for venous thromboembolism prophylaxis in high-risk surgical patients:a systematic review[J].J Arthroplasty,2016,31(2):524-532.
[15]丁雪芹,于守梅,姜霞霞,等.动静脉足泵对腰椎术后患者下肢深静脉血栓的预防效果[J].中国实用护理杂志,2017,33(2):1952-1955.
[16]FLAM E,BERRY S,COYLE A,et al.Blood-flow augmentation of intermittent pneumatic compression systems used for prevention of deep vein thrombosis prior to surgey[J].AM J Surg,1996,171(7):312-315.
[17]CLOTS(Clots in Legs Or s Tockings after Stroke)Trials Collaboration.Effect of intermittent pneumatic compression on disability,living circumstances,quality of life,and hospital costs after stroke:secondary analyses from CLOTS 3,a randomised trial[J].Lancet Neurol,2014,13(12):1186-1192.
[18]DENNIS M,SANDERCOCK P,GRAHAM C,et al.The Clots in Legs Or s Tockings after Stroke(CLOTS)3 trial:a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of poststroke deep vein thrombosis and to estimate its cost-effectiveness[J].Health Technol Assess,2015,19(76):1-90.
[19]HANKEY G J.Intermittent pneumatic compression after stroke[J].Lancet Neurol,2014,13(12):1163-1165.