急性深静脉血栓患者早日下床活动可行性与安全性的系统评价

发布时间：2018-06-18 19:57

本文选题：静脉血栓形成 + 肺栓塞　；参考：《中华护理杂志》2017年05期

【摘要】：目的探讨急性深静脉血栓患者早日下床活动的可行性及安全性。方法计算机检索中英文数据库中关于急性深静脉血栓患者早期活动的临床对照试验,同时筛检纳入的参考文献。由2名研究者对文献质量进行严格评价和资料提取,对符合质量标准的随机对照研究进行Meta分析。结果共纳入13篇文献,10篇为随机对照研究,3篇临床对照试验。Meta分析结果显示:与卧床休息相比,早日下床活动不增加深静脉血栓急性期患者继发新鲜肺栓塞的发生率[早期活动:22/1 408;卧床休息:34/1 417;RR=0.62,95%CI(0.37,1.03)]、深静脉血栓形成的发生率[早期活动:48/1 523;卧床休息:45/1 525;RR=0.85,95%CI(0.58,1.24)]。早期活动对患者病死率、肿胀、疼痛症状缓解方面,差异无统计学意义。结论深静脉血栓急性期患者早日下床活动不增加血栓进展及继发新鲜肺栓塞的发生率;同时,不能明显缓解深静脉血栓患者肿胀、疼痛症状,但可以降低深静脉血栓患者急性期中、重度疼痛的程度。
[Abstract]:Objective to investigate the feasibility and safety of getting out of bed early in patients with acute deep venous thrombosis. Methods the clinical controlled trials of early activity of patients with acute deep venous thrombosis were searched by computer in Chinese and English database. The literature quality was evaluated strictly by two researchers and the data was extracted, and the randomized controlled study which met the quality standard was analyzed by meta-analysis. Results A total of 13 articles were included, 10 were randomized controlled trials and 3 were clinical controlled trials. The results of Meta-analysis showed that: compared with bed rest, Early getting out of bed did not increase the incidence of secondary fresh pulmonary embolism in patients with acute deep venous thrombosis (early activity: 22 / 1 408; bed rest: 34 / 1 417; RRN: 0.6295 CIQ 0.37 / 1.03)], the incidence of deep venous thrombosis [early activity: 48 / 1 523; bed-rest: 451.5% RRN 0.895 CI 0.581.24]. There was no significant difference in mortality, swelling, and pain relief from early activity. Conclusion early removal from bed in patients with acute deep venous thrombosis does not increase the incidence of thrombus progression and secondary fresh pulmonary embolism, at the same time, it can not significantly alleviate the swelling and pain symptoms in patients with deep venous thrombosis. But it can reduce the degree of moderate and severe pain in patients with deep venous thrombosis.
【作者单位】：中国医学科学院北京协和医院重症医学科;中国医学科学院北京协和医院外科;中国医学科学院北京协和医院骨科;中国医学科学院北京协和医院血管外科;
【分类号】：R473.5

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