【摘要】 目的 观察并总结联合策略预防老年慢性阻塞性肺疾病急性加重期（AECOPD）患者发生下肢深静脉血栓（DVT）的效果。方法 收集2021年6月至2024年4月于亳州市人民医院住院接受治疗的老年AECOPD患者的临床资料，按照住院期间针对下肢DVT的预防措施的不同将患者分为联合组和对照组，每组66例。联合组患者在入院经评估无显著出血风险后开始启动低分子肝素钠治疗联合踝泵运动，对照组患者仅按同样策略给予低分子肝素钠治疗。比较两组患者住院期间的治疗情况和治疗结局，主要观察指标为住院期间下肢DVT的发生率，次要观察指标为住院期间药物相关出血的发生率、出院之前复查的凝血功能指标等。结果 部分患者因病情危重入住重症监护室，少数患者还接受了机械通气等积极治疗，但两组患者的主要治疗措施比较，差异均无统计学意义（P﹥0.05）。住院期间，联合组患者下肢DVT的发生率低于对照组患者，差异有统计学意义（P﹤0.05）。两组患者入院时与出院前复查的凝血酶原时间和活化部分凝血活酶时间比较，差异均无统计学意义（P﹥0.05）。两组患者住院期间均未发生药物治疗相关的出血。结论 低分子肝素钠联合踝泵运动可以降低老年AECOPD患者住院期间发生下肢DVT的风险，同时没有增加患者出血的风险。更多还原

【Abstract】 Objective To observe and summarize the effect of low molecular weight heparin combined with ankle pump exercise in preventing lower extremity deep vein thrombosis (DVT) in elderly patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Method The clinical data of elderly AECOPD patients admitted to Bozhou People’s Hospital for treatment from June 2021 to April 2024 were collected. According to the different preventive measures for lower extremity DVT during hospitalization, the patients were divided into combination group and control group, with 66 cases in each group. The patients in the combination group started low molecular weight heparin combined with ankle pump exercise immediately after admission and were assessed to have no significant bleeding risk, the patients in the control group were only treated with low molecular weight heparin sodium according to the same strategy. The treatment status and outcomes of two groups of patients during hospitalization were compared, with the main outcome measure being the incidence of lower extremity DVT during hospitalization, and the secondary outcome measures being the incidence of drug-related bleeding during hospitalization and coagulation function indicators rechecked before discharge. Result Some patients were admitted to the intensive care unit due to their critical condition, and a few patients also received active treatment such as mechanical ventilation. However, there was no statistically significant difference in the main treatment measures between the two groups of patients (P>0.05). During hospitalization, the incidence of lower extremity DVT in the combination group was lower than that in the control group, and the difference was statistically significant (P<0.05). There were no statistically significant differences in the prothrombin time and activated partial thromboplastin time between the two groups of patients at admission and before discharge (P>0.05). Neither group of patients experienced medication related bleeding during hospitalization. Conclusion Low molecular weight heparin sodium combined with ankle pump exercise can significantly reduce the risk of lower extremity DVT during hospitalization in elderly AECOPD patients, without increasing the risk of bleeding.更多还原