空气波压力疗法预防脑卒中患者下肢深静脉血栓形成的研究
发布时间：2018-11-18 21:22
【摘要】：目的:探讨空气波压力疗法对脑卒中患者下肢深静脉血流动力学和凝血功能的影响,分析空气波压力疗法预防脑卒中患者深静脉血栓形成的机制。本研究通过超声检测下肢静脉血流动力学的变化,筛选出空气波压力治疗仪的最适治疗参数(治疗模式和治疗压力)。然后将其应用于脑卒中康复治疗上,检测脑卒中患者治疗前后血流动力学及凝血功能的变化情况,分析空气波压力疗法能够预防脑卒中患者深静脉血栓形成的机制。方法:首先选取20名正常青年人,利用彩色多普勒超声检测这20名正常人在使用不同治疗模式(模式A、模式B)下,不同治疗压力(40 mm Hg、60 mm Hg、80 mm Hg、100 mm Hg)的空气波压力治疗仪干预后,不同时间段(静息状态下、干预后立即、干预后20分钟、干预后40分钟、干预后60分钟)的左下肢股总静脉血流动力学变化情况,从中筛选出空气波压力治疗仪最适治疗参数(治疗模式和治疗压力)。然后再选取20名脑卒中患者,使用最适治疗参数的空气波压力治疗仪治疗。利用彩色多普勒超声检测这20名脑卒中偏瘫患者双下肢在治疗前后,不同时间段(静息状态下、干预后立即、干预后20分钟、干预后40分钟、干预后60分钟)股总静脉血流动力学变化情况和出入院时患者凝血功能指标变化情况。结果:1.基于不同治疗模式和压力的空气波压力疗法对正常人下肢深静脉血流动力学的研究:(1)模式A(1)组内比较:干预后四组血流峰速度、平均速度、血流量较静息状态下显著增高(P0.05)。然而随着干预结束后时间的延长,四组血流动力学指标逐渐恢复到干预前水平。(2)组间比较:四组静息状态下血流峰速度、血流平均速度及血流量比较差异无统计学意义(P0.05);干预结束后40 min内四组间血流峰速度、血流平均速度及血流量比较差异有统计学意义(P0.05),干预后60 min四组间血流峰速度和血流平均速度比较差异有统计学意义(P0.05),血流量比较差异无统计学意义(P0.05)。(2)模式B(1)组内比较:干预后四组血流峰速度、平均速度、血流量较静息状态下显著增高(P0.05)。然而随着干预结束后时间的延长,四组血流动力学指标逐渐恢复到干预前水平。(2)组间比较:静息状态下四组血流峰速度、血流平均速度及血流量比较差异无统计学意义(P0.05);干预结束后40 min内四组间血流峰速度、血流平均速度及血流量比较差异有统计学意义(P0.05),干预后60 min四组间血流动力学指标比较差异无统计学意义(P0.05)。2.基于空气波压力疗法预防脑卒中患者下肢深静脉血栓形成的研究:(1)静息状态下健患侧比较入院:与健侧相比患侧血流峰速度、血流平均速度显著降低(P0.05),健患侧血流量比较差异无统计学意义(P0.05),出院时健患侧比较结果同入院。(2)血流动力学变化情况入院:干预后健患侧血流峰速度、平均速度、血流量较静息状态下显著增高(P0.05),然而随着干预结束后时间的延长,健患侧血流动力学指标逐渐减慢,其中患侧血流动力学指标在干预结束40分钟后逐渐恢复到静息水平。出院:健患侧血流动力学指标变化情况,基本与治疗前相同。(3)凝血功能比较与入院相比出院时纤维蛋白原含量明显降低(P0.05),其余凝血功能指标比较差异无统计学意义(P0.05)。结论:1.空气波压力治疗仪在工作模式A,治疗压力为80mm Hg时,促进静脉血液回流的效果最佳,对正常人而言停用空气波压力治疗仪60分钟时静脉血流动力学指标接近使用前水平;2.空气波压力疗法能够促进脑卒中患者下肢血液的回流,改善下肢静脉血液瘀滞的情况,患肢的治疗效果可持续至干预结束后40分钟;3.重复使用空气波压力疗法不会延长加速静脉血液回流的持续时间,但是能够改善凝血功能;4.建议脑卒中患者健患侧均接受IPC治疗,以便更好的降低DVT形成的风险。
[Abstract]:Objective: To study the effect of air wave pressure therapy on the hemodynamics and coagulation of lower limbs of patients with stroke, and to analyze the mechanism of air wave pressure therapy in the prevention of deep venous thrombosis in patients with stroke. The optimal treatment parameters (treatment mode and treatment pressure) of the air wave pressure therapeutic apparatus were selected by the change of the flow dynamics of the venous blood of the lower limbs by means of ultrasound. Then it is applied to the treatment of stroke rehabilitation, and the changes of blood flow dynamics and coagulation function before and after the treatment of stroke patients are detected, and the mechanism of the formation of deep vein thrombosis in patients with stroke can be prevented by the analysis of air wave pressure therapy. Methods: 20 normal young people were selected, and the 20 normal persons were detected by color Doppler ultrasound in different treatment modes (mode A and mode B). After the intervention of the air wave pressure therapeutic apparatus with different treatment pressure (40 mm Hg, 60 mm Hg, 80 mm Hg, 100 mm Hg), The optimal treatment parameters (treatment mode and treatment pressure) of the air wave pressure therapeutic apparatus were selected for different time periods (at rest, immediately after intervention, 20 minutes after intervention, 40 minutes after intervention, and 60 minutes after intervention). Then, 20 stroke patients were selected, and the optimal treatment parameters were used for the treatment of the air wave pressure therapeutic apparatus. The two lower limbs of the 20 stroke patients with hemiplegia were detected by color Doppler ultrasound before and after treatment, in different time periods (resting state, immediately after intervention, 20 minutes after intervention, and 40 minutes after the intervention, The changes of blood flow dynamics in the total venous blood flow in 60 minutes after intervention and the change of the coagulation function of the patients at the time of the entrance and exit. Results: 1. The study of air wave pressure therapy based on different treatment modes and pressure on the hemodynamics of the deep venous blood of the lower limbs of the normal person: (1) The comparison of the model A (1): the velocity of the four groups of blood flow, the average speed and the blood flow in the four groups after the intervention were significantly higher than those in the rest state (P0.05). However, with the extension of time after the end of the intervention, the four groups of hemodynamic indexes were gradually restored to the pre-intervention level. (2) There was no significant difference in the blood flow peak velocity, the average velocity of the blood flow and the blood flow in the four groups at rest (P0.05), and the difference of the blood flow peak velocity, the average velocity of the blood flow and the blood flow in the four groups after the intervention was statistically significant (P0.05). There was no significant difference in the velocity of blood flow and the average velocity of blood flow at 60 min after intervention (P0.05), and the difference of blood flow was not significant (P0.05). (2) In group B (1) group, the velocity, mean velocity and blood flow of four groups of blood flow were significantly higher than those in the rest (P0.05). However, with the extension of time after the end of the intervention, the four groups of hemodynamic indexes were gradually restored to the pre-intervention level. (2) There was no significant difference in the velocity of blood flow, the average velocity of blood flow and the flow of blood flow in the four groups at rest (P0.05), and there was a significant difference in the velocity of blood flow, the average velocity of blood flow and the flow of blood flow within 40 minutes after the end of the intervention (P0.05). There was no significant difference in the hemodynamic indexes between the four groups after the intervention (P0.05). A study on the prevention of deep venous thrombosis in the lower extremities of patients with stroke based on air-wave pressure therapy: (1) In resting state, the patient was admitted to the hospital: the velocity of the side blood flow and the average velocity of the blood flow were significantly lower than that of the healthy side (P0.05). There was no significant difference in the blood flow between the healthy and healthy side (P <0.05), and the result of the patient's side comparison at the time of discharge was the same as that of the hospital. (2) The changes of blood flow dynamics were admitted: the peak velocity, the average velocity and the blood flow in the post-intervention group were significantly higher than that of the rest (P0.05). However, with the prolongation of the time after the end of the intervention, the hemodynamic index of the healthy side was gradually reduced. At the end of the intervention, the hemodynamic index was gradually restored to the resting level. Discharge: The change of the hemodynamic index on the patient side is basically the same as before treatment. (3) The blood coagulation function was significantly lower than that of admission (P0.05), and the other coagulation function indexes were not statistically significant (P0.05). Conclusion: 1. When the air wave pressure therapeutic apparatus is in the working mode A, the treatment pressure is 80mm Hg, the effect of promoting the venous blood reflux is the best, and the hemodynamic index of the venous blood is close to the pre-use level when the air wave pressure therapeutic apparatus is stopped for 60 minutes for the normal person; and 2. The air wave pressure therapy can promote the return of the blood in the lower limbs of the patients with stroke, improve the blood stasis in the venous blood of the lower limbs, and the treatment effect of the patients with the limb can be continued until the end of the intervention for 40 minutes; and 3. Repeated use of air wave pressure therapy does not prolong the duration of accelerated venous blood reflux, but can improve the coagulation function; 4. It is recommended that the patient side of the stroke patient receive the IPC treatment in order to better reduce the risk of DVT formation.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3
本文编号：2341286
[Abstract]:Objective: To study the effect of air wave pressure therapy on the hemodynamics and coagulation of lower limbs of patients with stroke, and to analyze the mechanism of air wave pressure therapy in the prevention of deep venous thrombosis in patients with stroke. The optimal treatment parameters (treatment mode and treatment pressure) of the air wave pressure therapeutic apparatus were selected by the change of the flow dynamics of the venous blood of the lower limbs by means of ultrasound. Then it is applied to the treatment of stroke rehabilitation, and the changes of blood flow dynamics and coagulation function before and after the treatment of stroke patients are detected, and the mechanism of the formation of deep vein thrombosis in patients with stroke can be prevented by the analysis of air wave pressure therapy. Methods: 20 normal young people were selected, and the 20 normal persons were detected by color Doppler ultrasound in different treatment modes (mode A and mode B). After the intervention of the air wave pressure therapeutic apparatus with different treatment pressure (40 mm Hg, 60 mm Hg, 80 mm Hg, 100 mm Hg), The optimal treatment parameters (treatment mode and treatment pressure) of the air wave pressure therapeutic apparatus were selected for different time periods (at rest, immediately after intervention, 20 minutes after intervention, 40 minutes after intervention, and 60 minutes after intervention). Then, 20 stroke patients were selected, and the optimal treatment parameters were used for the treatment of the air wave pressure therapeutic apparatus. The two lower limbs of the 20 stroke patients with hemiplegia were detected by color Doppler ultrasound before and after treatment, in different time periods (resting state, immediately after intervention, 20 minutes after intervention, and 40 minutes after the intervention, The changes of blood flow dynamics in the total venous blood flow in 60 minutes after intervention and the change of the coagulation function of the patients at the time of the entrance and exit. Results: 1. The study of air wave pressure therapy based on different treatment modes and pressure on the hemodynamics of the deep venous blood of the lower limbs of the normal person: (1) The comparison of the model A (1): the velocity of the four groups of blood flow, the average speed and the blood flow in the four groups after the intervention were significantly higher than those in the rest state (P0.05). However, with the extension of time after the end of the intervention, the four groups of hemodynamic indexes were gradually restored to the pre-intervention level. (2) There was no significant difference in the blood flow peak velocity, the average velocity of the blood flow and the blood flow in the four groups at rest (P0.05), and the difference of the blood flow peak velocity, the average velocity of the blood flow and the blood flow in the four groups after the intervention was statistically significant (P0.05). There was no significant difference in the velocity of blood flow and the average velocity of blood flow at 60 min after intervention (P0.05), and the difference of blood flow was not significant (P0.05). (2) In group B (1) group, the velocity, mean velocity and blood flow of four groups of blood flow were significantly higher than those in the rest (P0.05). However, with the extension of time after the end of the intervention, the four groups of hemodynamic indexes were gradually restored to the pre-intervention level. (2) There was no significant difference in the velocity of blood flow, the average velocity of blood flow and the flow of blood flow in the four groups at rest (P0.05), and there was a significant difference in the velocity of blood flow, the average velocity of blood flow and the flow of blood flow within 40 minutes after the end of the intervention (P0.05). There was no significant difference in the hemodynamic indexes between the four groups after the intervention (P0.05). A study on the prevention of deep venous thrombosis in the lower extremities of patients with stroke based on air-wave pressure therapy: (1) In resting state, the patient was admitted to the hospital: the velocity of the side blood flow and the average velocity of the blood flow were significantly lower than that of the healthy side (P0.05). There was no significant difference in the blood flow between the healthy and healthy side (P <0.05), and the result of the patient's side comparison at the time of discharge was the same as that of the hospital. (2) The changes of blood flow dynamics were admitted: the peak velocity, the average velocity and the blood flow in the post-intervention group were significantly higher than that of the rest (P0.05). However, with the prolongation of the time after the end of the intervention, the hemodynamic index of the healthy side was gradually reduced. At the end of the intervention, the hemodynamic index was gradually restored to the resting level. Discharge: The change of the hemodynamic index on the patient side is basically the same as before treatment. (3) The blood coagulation function was significantly lower than that of admission (P0.05), and the other coagulation function indexes were not statistically significant (P0.05). Conclusion: 1. When the air wave pressure therapeutic apparatus is in the working mode A, the treatment pressure is 80mm Hg, the effect of promoting the venous blood reflux is the best, and the hemodynamic index of the venous blood is close to the pre-use level when the air wave pressure therapeutic apparatus is stopped for 60 minutes for the normal person; and 2. The air wave pressure therapy can promote the return of the blood in the lower limbs of the patients with stroke, improve the blood stasis in the venous blood of the lower limbs, and the treatment effect of the patients with the limb can be continued until the end of the intervention for 40 minutes; and 3. Repeated use of air wave pressure therapy does not prolong the duration of accelerated venous blood reflux, but can improve the coagulation function; 4. It is recommended that the patient side of the stroke patient receive the IPC treatment in order to better reduce the risk of DVT formation.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3
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