防足下垂气压牵引带在静脉血栓高危风险的 下肢骨折患者中的应用研究

Application of an Anti-Foot Drop Pneumatic Traction Device in Patients with Lower Limb Fractures at High Risk of Venous Thromboembolism

摘要: 目的：介绍防治足下垂气压牵引带的设计及临床应用，探索其在静脉血栓高危风险的下肢骨折患者中预防血栓及防治足下垂的效果。方法：选取2022年1月~2024年3月下肢骨折患者110例，采用随机信封法分为实验组(55例)和对照组(55例)，实验组采用常规护理联合防足下垂气压牵引带治疗4周，对照组采用规范常规护理(含基础宣教、踝泵运动、下肢抬高、间歇充气加压泵、低分子肝素药物预防) 4周；所有结局指标由未参与分组与干预的专职人员评估，未实施评估者完全盲法。观察两组患者踝背屈角度、深静脉血栓形成、压力性损伤发生率及患者满意度。结果：两组患者术后下肢彩色超声检查均未发现新发DVT，D-二聚体变化值均降低，实验组患者较对照组降低幅度大，踝背屈角度均上升，实验组患者1周后的踝背屈角度较对照组明显增加，4周后实验组及对照组患者均趋于踝关节活动正常范围，实验组效果更明显，且组间数据比较均具有统计学意义(P < 0.05)。两组患者的患者满意度、治疗依从性评分均上升，实验组患者的评分较对照组明显升高，数据比较均具有统计学意义(P < 0.05)，不良事件发生率无差异(P > 0.05)。结论：本研究初步表明，该新型设备在改善下肢骨折患者的踝关节功能和VTE相关血清学指标方面具有潜力，但其在预防临床DVT事件方面的有效性仍需通过设计更严谨的大样本多中心随机对照试验进一步证实。

Abstract: Objective: To introduce the design and clinical application of a pneumatic traction device for preventing foot drop, and to evaluate its effectiveness in preventing venous thromboembolism (VTE) and foot drop in patients with lower limb fractures at high risk of VTE. Methods: A total of 110 patients with lower limb fractures from January 2022 to March 2024 were randomly divided into an experimental group (55 cases) and a control group (55 cases) using a random envelope method. The experimental group received routine nursing care combined with the anti-foot drop pneumatic traction device for 4 weeks, while the control group received standard routine nursing care (including basic education, ankle pump exercises, leg elevation, intermittent pneumatic compression, and low-molecular-weight heparin prophylaxis) for 4 weeks. All outcome measures were assessed by independent evaluators who were not involved in group allocation or intervention, and the assessors were completely blinded. The ankle dorsiflexion angle, incidence of deep vein thrombosis (DVT), pressure injury rate, and patient satisfaction were observed. Results: Postoperative color Doppler ultrasound of the lower limbs revealed no new DVT in either group. D-dimer levels decreased in both groups, with a greater reduction in the experimental group than in the control group. Ankle dorsiflexion angles increased in both groups; after 1 week, the experimental group showed a significantly greater increase than the control group. After 4 weeks, patients in both groups achieved ankle mobility within the normal range, with more pronounced improvement in the experimental group. Between-group differences were statistically significant (P < 0.05). Patient satisfaction and treatment adherence scores increased in both groups, with significantly higher scores in the experimental group (P < 0.05). No significant difference was observed in the incidence of adverse events (P > 0.05). Conclusion: This study preliminarily indicates that the novel device has potential in improving ankle joint function and VTE-related serological markers in patients with lower limb fractures. However, its efficacy in preventing clinical DVT events needs to be further confirmed through more rigorously designed, large-scale, multicenter randomized controlled trials.