本文關(guān)鍵詞：間歇充氣加壓泵對預防內(nèi)科危重癥患者VTE效果及安全的系統(tǒng)評價　出處：《重慶醫(yī)科大學學報》2016年09期 　論文類型：期刊論文

  更多相關(guān)文章： 間歇充氣壓力泵 靜脈血栓栓塞癥 內(nèi)科重癥患者 Meta分析

【摘要】：目的:探索利用間歇充氣壓力泵(intermittent pneumatic compression,IPC)預防重癥內(nèi)科患者的有效性及安全性,為臨床合理有效利用氣壓泵預防靜脈血栓栓塞癥(venous thromboembolism,VTE)提供循證依據(jù)。方法:通過檢索中外文數(shù)據(jù)庫收集關(guān)于研究IPC預防重癥內(nèi)科住院患者VTE的隨機對照試驗的文獻,運用Rev Man5.3軟件進行統(tǒng)計處理。結(jié)果:納入文獻19篇,Meta分析顯示,與對照組相比較,IPC組在預防下肢深靜脈血栓(deep venous thrombosis,DVT)的發(fā)生率明顯降低(RR=0.25,95%CI=0.15~0.41,P=0.000),盡管存在較大的異質(zhì)性(I2=63%,P=0.000),但其亞組分析顯示其發(fā)生率明顯低于對照組(RR=0.17,95%CI=0.11~0.27,P=0.000)、(RR=0.23,95%CI=0.16~0.33,P=0.006),在肺血栓栓塞的發(fā)生率方面并沒有明顯降低(RR=0.66,95%CI=0.43~1.02,P=0.060);在與使用對照組的比較中,IPC組在預防VTE發(fā)生率也明顯降低(RR=0.37,95%CI=0.17~0.79,P=0.010),但存在較大的異質(zhì)性(I2=73%,P=0.005),按IPC干預時間的不同進行亞組分析能消除其異質(zhì)性(RR=0.76,95%CI=0.66~0.88,P=0.000),(RR=0.15,95%CI=0.07~0.35,P=0.000)。與使用抗凝劑比較,IPC組在預防下肢DVT發(fā)生并無統(tǒng)計學差異(RR=2.47,95%CI=0.79~7.75,P=0.120),但出血的風險明顯降低(RR=0.45,95%CI=0.22~0.92,P=0.030)。結(jié)論:IPC能夠有效地預防內(nèi)科危重癥患者下肢DVT和總的靜脈血栓事件的發(fā)生;與藥物抗凝相比,IPC除了能有效規(guī)避出血風險以外,還可以有效地預防下肢DVT的發(fā)生產(chǎn)生與藥物抗凝相當?shù)目顾ㄐЧ?br/>[Abstract]:Objective: To explore the use of intermittent pneumatic pressure pump (intermittent pneumatic, compression, IPC) to prevent the effectiveness and safety of patients with severe medicine, reasonable and effective use of pneumatic pump for clinical prevention of venous thromboembolism (venous thromboembolism VTE) provides evidence-based basis. Methods: by collecting the literatures on IPC prevention of a randomized controlled trial in patients with VTE hospitalized severe medical retrieval database, statistical processing using Rev Man5.3 software. Results: 19 studies, Meta analysis showed that, compared with the control group, IPC group in the prevention of deep vein thrombosis (deep venous, thrombosis, DVT) was significantly decreased (RR=0.25,95%CI=0.15~0.41, P=0.000), although there is heterogeneity the larger (I2=63%, P=0.000), but the subgroup analysis showed that the incidence rate was significantly lower than the control group (RR=0.17,95%CI=0.11~ 0.27, P=0.000 (RR=0.23,95%CI=0.16~0.3). 3, P=0.006), the incidence of pulmonary embolism is not significantly reduced (RR=0.66,95%CI=0.43~1.02, P=0.060); and in the use of a control group comparison, IPC group in the prevention of the incidence of VTE was significantly reduced (RR=0.37,95%CI=0.17~0.79, P=0.010), but there is considerable heterogeneity (I2=73%, P=0.005), according to the intervention time of IPC different subgroup analysis can eliminate the heterogeneity (RR=0.76,95%CI=0.66~0.88, P=0.000), (RR=0.15,95%CI=0.07~0.35, P=0.000). Compared with the use of anticoagulants, IPC group had no significant difference in the prevention of lower extremity DVT (RR=2.47,95%CI=0.79~7.75, P=0.120), but significantly reduced the risk of bleeding (RR=0.45,95%CI=0.22~0.92, P=0.030). Conclusion: IPC can effectively prevent thrombosis critically ill patients with lower extremity venous events DVT and total occurrence; compared with anticoagulant, IPC can effectively avoid the risk of bleeding, but also can effectively pre The antithrombotic effect of the anti DVT of the lower extremities is equivalent to that of the anticoagulant drug.

【作者單位】： 重慶醫(yī)科大學附屬第一醫(yī)院呼吸內(nèi)科;
【分類號】：R459.7
【正文快照】： 靜脈血栓栓塞癥(venous thromboembolism,VTE)包括肺栓塞(pulmonary embolism,PE)和深靜脈血栓形成(deep venous thrombosis,DVT),作為住院患者一種潛在的嚴重并發(fā)癥,它的預防已經(jīng)成為醫(yī)師對住院患者疾病管理中不容忽視的部分。盡管在外科手術(shù)病人中血栓預防的重要性早已為醫(yī)

【相似文獻】

相關(guān)期刊論文 前10條

1 劉澤霖;劉敏涓;;癌癥病人并發(fā)靜脈血栓栓塞癥的處置[J];血栓與止血學;2012年04期

2 鄧怡;陳曉品;;惡性腫瘤相關(guān)靜脈血栓栓塞癥的研究進展[J];臨床腫瘤學雜志;2013年08期

3 浦國梅;鄭海燕;呂一蘭;;腫瘤患者靜脈血栓栓塞癥的預防護理[J];中國誤診學雜志;2011年25期

4 安美葉;張慶兵;陳俊芳;;惡性腫瘤患者靜脈血栓栓塞癥的護理研究[J];中國藥物與臨床;2013年03期

5 劉曉涵;盧根娣;;國外靜脈血栓栓塞癥風險評估工具的研究進展[J];護理學雜志;2014年12期

6 李圣青;;腫瘤相關(guān)性靜脈血栓栓塞癥的預防[J];中華肺部疾病雜志(電子版);2013年05期

7 趙建美;倪松石;仇永貴;曹德林;;我院靜脈血栓栓塞癥防治管理體系的構(gòu)建與實施[J];江蘇衛(wèi)生事業(yè)管理;2014年01期

8 胡艷霞;韓文周;劉彥中;;開胸術(shù)后合并靜脈血栓栓塞癥的臨床分析及護理對策[J];中國民康醫(yī)學;2011年19期

9 冉孟良;;骨科術(shù)后預防靜脈血栓栓塞癥管理體會[J];吉林醫(yī)學;2010年21期

10 董啟玉;;重癥監(jiān)護室病人發(fā)生靜脈血栓栓塞癥的危險因素及護理對策[J];全科護理;2013年02期

相關(guān)碩士學位論文 前1條

1 劉曉涵;住院患者靜脈血栓栓塞癥風險評估工具的應(yīng)用研究[D];第二軍醫(yī)大學;2015年

，

本文編號：1374125