通讯作者: 孙辉, 19905839558@163.com

DOI：10.12201/bmr.202503.00088

The prophylactic value of electroacupuncture combined with antithrombotic compression banding for DVT in neurocritical care patients at high risk for VTE

• 摘要：目的 探讨电针联合抗血栓压力带对神经危重症高危静脉血栓栓塞症(VTE)患者深静脉血栓形成(DVT)的预防价值。方法 选取2023年4月～2024年5月收治的神经危重症高危VTE患者98例,采用随机数字表法分为49例。两组均给予低分子量肝素钠预防血栓,压力带组给予抗血栓压力带干预,电针组在抗血栓压力带基础上联合电针干预,持续治疗14d。检测两组治疗前以及治疗7d、14d患者D-二聚体(D-D)、白细胞介素-6(IL-6)、纤维蛋白原(FIB)、细胞间黏附分子-1(ICAM-1)、活化部分凝血活酶时间(APTT)、肿瘤坏死因子-α(TNF-α)、凝血酶原时间(PT)变化,评估两组治疗前以及治疗7d、14d患者日常生活活动能力(ADL)评分差异,统计两组VTE、压痛、浅静脉曲张的发生率。结果 两组治疗前D-D、FIB、APTT、PT、炎症指标比较均无差异(P＞0.05)。两组治疗7d、14d的D-D、FIB、IL-6、ICAM-1、TNF-α均较治疗前降低,APTT、PT均较治疗前升高(P<0.05)。电针组治疗7d、14d的D-D、FIB、IL-6、ICAM-1、TNF-α低于压力带组(P<0.05)。电针组治疗7d的APTT、PT高于压力带组(P<0.05),但电针组治疗14d的APTT、PT与压力带组比较无差异(P＞0.05)。两组治疗前ADL评分比较均无差异(P＞0.05)。两组治疗7d、14d的ADL评分均较治疗前升高(P<0.05),且电针组治疗7d、14d的ADL评分高于压力带组(P<0.05)。电针组VTE发生率、压痛发生率、浅静脉曲张发生率均低于压力带组(P<0.05)。结论 电针联合抗血栓压力带可神经危重症高危VTE患者,减轻炎症反应,改善凝血功能,降低VTE、压痛、浅静脉曲张的发生。

  关键词： 电针; 抗血栓压力带; 神经危重症; 高危; 静脉血栓栓塞症; 深静脉血栓形成

   

  Abstract: Objective To investigate the prophylactic value of electroacupuncture combined with antithrombotic compression taping for deep vein thrombosis (DVT) in neurocritical high risk venous thromboembolism (VTE) patients.Methods Ninety-eight cases of high-risk VTE patients with neurocritical illness admitted from April 2023 to May 2024 were selected and divided into 49 cases using random number table method. Both groups were given low molecular heparin calcium to prevent thrombosis, the pressure band group was given antithrombotic pressure band intervention, and the electro-acupuncture group was combined with electro-acupuncture intervention on the basis of antithrombotic pressure band, and the treatment was continued for 14 d. D-dimer (D-D), interleukin-6 (IL-6), fibrinogen (FIB), intercellular adhesion molecule-1 (ICAM-1), activated partial thromboplastin time (APT), and activated partial thromboplastin time (APT) were measured in the patients in the two groups before the treatment, as well as in those who received the treatment for 7d and 14d. ), activated partial thromboplastin time (APTT), tumor necrosis factor-α (TNF-α), and prothrombin time (PT) changes, assessed the differences in the ability to perform activities of daily living (ADL) scores of the patients in the two groups before treatment as well as at 7d and 14d of treatment, and counted the incidence of VTE, pressure pain, and superficial varicose veins in the two groups.Results There was no difference in the comparison of D-D, FIB, APTT, PT, and inflammation indexes between the two groups before treatment (P>0.05). D-D, FIB, IL-6, ICAM-1, TNF-α of both groups in 7d and 14d of treatment were lower than before treatment, and APTT and PT were higher than before treatment (P<0.05). D-D, FIB, IL-6, ICAM-1, and TNF-α in the electroacupuncture group were lower than those in the pressure band group for 7d and 14d of treatment (P<0.05). The APTT and PT of the electroacupuncture group were higher than that of the pressure band group in 7d of treatment (P<0.05), but there was no difference between the APTT and PT of the electroacupuncture group and the pressure band group in 14d of treatment (P>0.05). There was no difference in the comparison of ADL scores before treatment between the two groups (P>0.05). The ADL scores of 7d and 14d of treatment in both groups were higher than those before treatment (P<0.05), and the ADL scores of 7d and 14d of treatment in the electroacupuncture group were higher than those in the pressure band group (P<0.05). The incidence of VTE, the incidence of pressure pain, and the incidence of superficial varicose veins in the electroacupuncture group were lower than those in the pressure band group (P<0.05).Conclusion Electroacupuncture combined with antithrombotic compression taping can neurocritically ill patients at high risk for VTE, reduce the inflammatory response, improve coagulation, and decrease the incidence of VTE, compression pain, and superficial varicose veins.

  Key words: Electroacupuncture; Antithrombotic compression banding; Neurocritical care; High risk; Venous thromboembolism; Deep vein thrombosis

  提交时间：2025-03-31

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  1	2025-02-28	bmr.202503.00088V1	下载

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