本文選題：靜脈血栓形成 + 肺栓塞��； 參考：《中華護(hù)理雜志》2017年05期

【摘要】：目的探討急性深靜脈血栓患者早日下床活動(dòng)的可行性及安全性。方法計(jì)算機(jī)檢索中英文數(shù)據(jù)庫中關(guān)于急性深靜脈血栓患者早期活動(dòng)的臨床對(duì)照試驗(yàn),同時(shí)篩檢納入的參考文獻(xiàn)。由2名研究者對(duì)文獻(xiàn)質(zhì)量進(jìn)行嚴(yán)格評(píng)價(jià)和資料提取,對(duì)符合質(zhì)量標(biāo)準(zhǔn)的隨機(jī)對(duì)照研究進(jìn)行Meta分析。結(jié)果共納入13篇文獻(xiàn),10篇為隨機(jī)對(duì)照研究,3篇臨床對(duì)照試驗(yàn)。Meta分析結(jié)果顯示:與臥床休息相比,早日下床活動(dòng)不增加深靜脈血栓急性期患者繼發(fā)新鮮肺栓塞的發(fā)生率[早期活動(dòng):22/1 408;臥床休息:34/1 417;RR=0.62,95%CI(0.37,1.03)]、深靜脈血栓形成的發(fā)生率[早期活動(dòng):48/1 523;臥床休息:45/1 525;RR=0.85,95%CI(0.58,1.24)]。早期活動(dòng)對(duì)患者病死率、腫脹、疼痛癥狀緩解方面,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論深靜脈血栓急性期患者早日下床活動(dòng)不增加血栓進(jìn)展及繼發(fā)新鮮肺栓塞的發(fā)生率;同時(shí),不能明顯緩解深靜脈血栓患者腫脹、疼痛癥狀,但可以降低深靜脈血栓患者急性期中、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.
【作者單位】： 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院重癥醫(yī)學(xué)科;中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院外科;中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院骨科;中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院血管外科;
【分類號(hào)】：R473.5

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