脑卒中患者合并下肢急性深静脉血栓早期康复策略

发布时间：2018-05-11 01:20

本文选题：脑卒中 + 深静脉血栓　；参考：《中国康复医学杂志》2017年07期

【摘要】：目的:探讨脑卒中合并下肢急性深静脉血栓(deep vein thrombosis,DVT)早期康复策略,为早期预防深静脉血栓及康复治疗提供可参考依据。方法:将42例脑卒中合并下肢急性DVT患者随机分成观察组和对照组,每组各21例,均给予抗凝药物治疗,观察组在发病早期DVT形成后1—2d内卧床休息,抬高患肢,根据血浆D-二聚体浓度,10d之内循序渐进地进行康复治疗。对照组发病后即予绝对卧床休息,抬高患肢,10d内严格制动;分别对两组临床表现、血浆D-二聚体浓度、血栓大小等指标进行观察。结果:第3d时,两组NVS疼痛评分均较治疗前提高(P0.05),小腿周径值较治疗前稍增粗(P0.05);第5d时,观察组NVS疼痛评分较治疗前下降(P0.05),对照组仍有明显疼痛(P0.05),两组小腿周径值较治疗前改变不明显;第10d时,两组NVS疼痛评分均较治疗前下降(P0.05),观察组较对照组下降更为明显(P0.05),两组小腿周径值均较治疗前缩小(P0.05),两组之间比较无显著性差异(P0.05),但观察组缩小幅度高于对照组(5.22%/1.92%)。两组血浆D-二聚体浓度较治疗前逐渐下降(P0.01),但第5d及第10d时,观察组下降幅度高于对照组(P0.05)。两组彩超定性检查无显著性差异(P0.05)。结论:对脑卒中合并下肢急性DVT患者早期有序合理的实施康复训练可以改善临床症状;血浆D-二聚体浓度可以作为运动剂量的参考标准,是早期康复训练有意义的指标。
[Abstract]:Objective: to explore the early rehabilitation strategy of acute deep venous thrombosis (DVT) complicated with acute deep venous thrombosis (DVT) of lower extremities, and to provide reference for early prevention and rehabilitation of deep venous thrombosis (DVT). Methods: 42 patients with acute DVT of lower extremity were randomly divided into two groups: the observation group (n = 21) and the control group (n = 21). The patients in each group were treated with anticoagulant drugs. The patients in the observation group were in bed rest and raised their limbs within 1 to 2 days after the early onset of DVT. According to plasma D-dimer concentration, rehabilitation therapy was carried out step by step within 10 days. The patients in the control group were given absolute bed rest and strict immobilization within 10 days after the onset of the disease. The clinical manifestations, plasma D-dimer concentration and thrombus size were observed in the two groups. Results: on the 3rd day, the pain score of NVS in both groups was higher than that before treatment (P 0.05), the circumference of the leg was slightly thicker than that before treatment (P 0.05), and at the 5th day, there was no significant difference between the two groups. The NVS pain score of the observation group was lower than that of the control group (P 0.05), while that of the control group was still marked (P 0.05). The circumference of the leg in the two groups was not significantly different from that before treatment, and on the 10th day, there was no significant difference between the two groups. The pain score of NVS in the two groups was lower than that before treatment (P 0.05), and the decrease in the observation group was more obvious than that in the control group (P 0.05). The circumference of the leg in both groups was smaller than that before treatment. There was no significant difference between the two groups (P 0.05), but the decrease in the observation group was higher than that in the control group (5.22 / 1.922). The plasma D-dimer concentration in both groups decreased gradually compared with that before treatment, but at the 5th and 10th day, the decrease of plasma D-dimer concentration in the observation group was higher than that in the control group. There was no significant difference in qualitative examination between the two groups (P 0.05). Conclusion: early rehabilitation training can improve clinical symptoms in stroke patients with acute lower extremity DVT, and plasma D-dimer concentration can be used as the reference standard of exercise dose, and it is a meaningful index of early rehabilitation training.
【作者单位】：湖南省人民医院康复医学科;长沙市第四医院康复医学科;
【分类号】：R493;R743.3

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