Effect of different muscle strength of lower extremity on deep venous thrombosis in patients with neurological ICU
10.3760/cma.j.issn.1672-7088.2019.30.007
- VernacularTitle: 神经内科ICU患者下肢不同肌力对深静脉血栓形成的影响
- Author:
Xin ZHANG
1
;
Fang LIU
;
Lichao GONG
;
Ting YANG
Author Information
1. Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing100053, China
- Publication Type:Journal Article
- Keywords:
Neurology;
Intensive care unit;
Lower extremity muscle strength;
Venous thrombosis;
Influencing factors
- From:
Chinese Journal of Practical Nursing
2019;35(30):2352-2357
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the correlation between different muscle strength of lower extremitiess and the formation of deep vein thrombosis (DVT) in neurological ICU patients, and to provide evidence for effective nursing intervention.
Methods:A questionnaire was developed to investigate the factors related to lower extremities DVT in patients with neurological ICU.By collecting clinical data of 195 patients from neurological ICU in Xuanwu Hospital of Capital Medical University, using the UK Medical Research Council(MRC) scale of freehand muscle strength for grading evaluation, patients were divided into a muscle strength grade 4-5 group (at least one extremities muscle strength grade 4) and a muscle strength grade 0-3 group (both lower extremities muscle strength grade 3).Gender, age, deep venous catheterization, Glasgow Coma Scale(GCS) score, bed time, fibrinogen value, D-dimer value were compared between the two groups.The main influencing factors of lower extremities DVT with different muscle strength were analyzed, and the incidence of lower extremities DVT with different muscle strength was compared.
Results:The comparison between muscle strength grade 4-5 group and muscle strength grade 0-3 group in neurological ICU patients showed that bed time, GCS score, and D-dimer of the 0-3 muscle strength group were 18.96(14.00, 27.00) d, 9.00(6.00, 10.15), and 2.15(1.24, 3.58) mg/L, while those of the 4-5 muscle strength group were 13.50(5.75, 22.00)d, 13.50(10.00, 15.00), 1.52(0.76, 2.99) mg/L, the difference was statistically significant (Z=-3.767, -5.811, -2.296, P<0.01 or 0.05).While gender, catheterization, fibrinogen, anticoagulant use and age had no statistical significance (P > 0.05). Grouping comparison of unilateral lower extremities muscle strength showed that the left lower extremities muscle strength group,the incidence of thrombosis in grade 0-3 group was 26.9%(32/119), and that in grade 4-5 group was 14.5%(11/76), the incidence of left lower extremities DVT had statistical significance (χ2=4.160, P<0.05),and the right lower extremities muscle strength group,the incidence of thrombosis was 32.8%(41/125) in the 0-3 group and 15.7%(11/70) in the 4-5 group, the incidence of right lower extremities DVT had statistical significance (χ2=6.698, P<0.05).
Conclusions:Patients with grade 0-3 lower extremities muscle strength in neurological ICU have more factors influencing DVT.The incidence of DVT is high in the lower extremities with unilateral extremities muscle strength grade 0-3, and early monitoring of lower extremities DVT should be strengthened to prevent the occurrence of lower extremities DVT.
