中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (46): 8703-.doi: 10.3969/j.issn.1673-8225.2010.46.037

• 组织构建临床实践 • 上一篇    下一篇

动静脉泵干预脊髓损伤合并深静脉血栓形成者股总静脉的血流动力学变化

孙永新，赵迎娱，刘宁   

  1. 中国医科大学附属第一医院康复科，辽宁省沈阳市  110000
  • 出版日期:2010-11-12 发布日期:2010-11-12
  • 作者简介:孙永新☆，男，1968年生，辽宁省沈阳市人，汉族，1991年中国医科大学毕业，博士，副教授，主要从事骨质疏松症和脊髓损伤的康复治疗等方面的研究。 zyy010@163.com
  • 基金资助:

    2008年辽宁省高等学校科研项目计划(2008842)。

Effects of arteriovenous foot pump on hemodynamic changes in the common femoral vein of patients with spinal cord injury complicated with deep vein thrombosis

Sun Yong-xin, Zhao Ying-yu, Liu Ning   

  1. Department of Rehabilitation, the First Hospital of China Medical University, Shenyang  110000, Liaoning Province, China
  • Online:2010-11-12 Published:2010-11-12
  • About author:Sun Yong-xin☆, Doctor, Associate professor, Department of Rehabilitation, the First Hospital of China Medical University, Shenyang 110000, Liaoning Province, China zyy010@163.com
  • Supported by:

    the Science and Technology Plan of Higher Education of Liaoning Province in 2008, No. 2008842*

PDF

345

被引次数

3

摘要：

背景：下肢深静脉血栓是脊髓损伤的常见并发症，动静脉泵对脊髓损伤后下肢深静脉血栓形成的预防作用已得到认可。
目的：观察动静脉泵对脊髓损伤后合并深静脉血栓形成患肢静脉血流的影响。
方法：纳入2008-01/2009-12在中国医科大学附属第一医院就诊的65岁以下既往无静脉血栓病史的脊髓损伤后合并深部静脉血栓患者17例作为病例组；同时选取同一时期脊髓损伤未合并深部静脉血栓的65岁以下患者20例作为对照组。在应用抗凝剂及循序减压弹力袜的基础上，对两组受试者实施3个月的动静脉泵治疗。在治疗前、治疗30 min、治疗停止即刻检测股总静脉的血流动力学参数。
结果与结论：在治疗30 min时，病例组及对照组股总静脉的最大血流速度、每分钟血流量均明显增加(P < 0.05)，但病例组不如对照组增加明显。超声血管二维声像图见病例组静脉管壁不规则、腔内见不均匀低回声、可见细束状血流信号；对照组静脉管腔可见均匀低回声、管壁规则、管腔壁充满血流信号。 停用动静脉泵治疗即刻，两组股总静脉最大血流速度和每分钟血流量均较治疗中有所下降(P < 0.05)，但仍较治疗前明显增加(P < 0.05)。在治疗4周后，静脉血流动力学参数均比治疗前显著改善。另外，通过 3个月动态观察，发现静脉最大血流速度呈进行性增快，峰值在4周。说明动静脉泵可以明显增加脊髓损伤合并及未合并深静脉血栓患者的下肢静脉血流量，改善微循环，是一种安全、有效的预防和治疗脊髓损伤患者下肢深部静脉血栓形成的重要手段。

关键词: 动静脉泵, 脊髓损伤, 深静脉血栓形成, 静脉超声血流改变, 血流动力学参数

Abstract:

BACKGROUND: Lower limb deep venous thrombosis is a common concurrent disease following spinal cord injury (SCI). Arteriovenous (A-V) foot pump has received acceptable effects on prevention the formation of lower limb deep venous thrombosis after SCI.
OBJECTIVE: To investigate effect of A-V foot pump on venous flow in patients with SCI complicated with deep vein thrombosis.
METHODS: All cases, under 65 ages, were selected from the First Hospital of China Medical University from January 2008 to December 2009. A total of 17 cases of SCI complicated with deep vein thrombosis were served as case group. At the same time, 20 cases of SCI without deep venuous thrombosis served as control group. All cases were treated by A-V foot pump on the base of routine dose aspirin and graduated elastic compression stocking without contraindications for 3 months. The hemodynamics of venous flow were measured pre-treatment, 30 minutes after treatment and the moment of stopping treatment (less than 60 seconds) by using Color Dopplar ultrasonography.
RESULTS AND CONCLUSION: After 30 minutes treatment, the maximal velocity of the vein (Vmax) and blood flow volume per minute in the common femoral vein of both groups were increased compared with before treatment (P < 0.05), however, the increase was smaller in the case group. Two-dimensional sonogram showed that, the irregular venous wall, irregular hypoechogenicity intracavity, and thin bundles blood flow signal could be found in the case group. Homogeneous hypoechogenicity, regular venous wall, and full of blood flow signal could be found in the control group. After stopping treatment, Vmax and blood flow volume per minute in the common femoral vein of both groups were lower than in the treatment (P < 0.05), but still increased compared with before (P < 0.05). The values of hemodynamics of venous flow were significantly augmented after 4 weeks treatment, and the Vmax of common femoral vein was increased, and peaked at 4 weeks after treatment. Both SCI-DVT and SCI groups, A-V foot pump may significantly increase the patient’s lower extremity venous blood flow and improve microcirculation function; make collateral circulation, which supplies a effective treatment for patients with SCI complicated with deep vein thrombosis.

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