不同靜脈血栓栓塞預防措施於人工膝關節置換術後病人效果之比較

Comparison of Different Venous Thromboembolism Prophylaxis Options in Patients after Total Knee Replacement

全人工膝關節置換術後使用抗血小板藥物或間歇性充氣加壓裝置能預防靜脈血栓栓塞，但對病人疼痛、腫脹、膝關節彎曲及活動功能待進一步討論。本研究探討不同靜脈血栓栓塞預防措施對術後病人疼痛、腿部腫脹程度、膝關節彎曲角度及活動功能之差異。研究工具含骨科角度測量尺、圍度測量尺、疼痛數字量表、Lysholm膝關節評分量表，共250位個案。結果顯示併用抗血小板藥物加間歇性充氣加壓裝置之疼痛、腿部腫脹程度及膝關節活動功能較其他二組佳，膝關節彎曲角度無顯著差異。併用抗血小板藥物加間歇性充氣加壓裝置，除預防靜脈血栓栓塞，同時降低病人的疼痛、腿部腫脹程度及促進膝關節活動功能。研究結果可提供醫療人員與病人進行醫病共享決策之實證參考資料。 The use of antiplatelet drugs or Intermittent Pneumatic Compression devices after total knee replacement can prevent venous thromboembolism, but the pain, swelling, knee flexion and activity of the patient remain to be further discussed. This study focused on the differences in the degree of pain, leg swelling, knee flexion angle and activity of different venous thromboembolic precautions. The research tools include orthopedic angle measuring scale, circumference measuring ruler, Numerical Rating Scale and Lysholm knee scale. A total of 250 participants were recruited. The results showed that the degree of pain, leg swelling and knee joint activity treated by antiplatelet drugs plus intermittent pneumatic compression device were better than those of the other two groups, and there was no significant difference in knee flexion angle. After the operation, antiplatelet drugs plus intermittent pneumatic compression device can be used to prevent the occurrence of venous thromboembolism, reduce the patient's pain level, degree of leg swelling and promote the knee joint activity function. The results of this study provide an evidence for clinical decision making.