| Research background:Early thromboprophylaxis is beneficial to reduce the incidence of lower extremity deep vein thrombosis（DVT）,but due to various reasons,thromboprophylaxis recommended by guidelines within 72 hours of admission is often difficult to carry out.Patients with ischemic stroke are at high risk of DVT,and patients need routine use of pneumatic pump to pre-thrombus after admission,but the incidence of DVT in patients with stroke is still high after the use of pneumatic pump.Bedbike is beneficial to promote venous blood circulation of lower limbs and the rehabilitation of limb function of patients.Currently,there is still controversy on the clinical effect of treadmill combined with pneumatic pump in preventing DVT.Research purpose:To investigate the effect of early bed bicycle combined with pneumatic pump on theprevention of lower extremity deep vein thrombosis in patients with ischemic stroke,so as to develop a safe and feasible prevention program for early deep vein thrombosis in patients with ischemic stroke.Research methods:This study was a randomized controlled experiment.A total of 132 patients with ischemic stroke admitted to the department of Neurology of a class A hospital in Zhejiang Province from January to December 2021 were selected and divided into experimental group and control group by random number table method,with 66 patients in each group.Patients in both groups were given deep vein thrombosis prevention measures within 72 hours after admission,while thecontrol group was given intermittent inflating pressure pump twice a day,30min each time to prevent thrombosis.On the basis of the control group,the experimental group increased the bed bicycle intervention twice a day for 30 minutes each time,and other treatments were the same.After 7 days of intervention,the incidence of DVT,clotting related indicators,lower extremity muscle strength score,circumference difference of large and small legs and patient satisfaction were compared between the two groups.Statistical analysis was performed using SPSS 21.0statistical software,and P<0.05 was considered statistically significant.Research Results:（1）Before intervention,there were no statistically significant differences in general data,clotting related indicators,lower limb muscle strength score,and difference in left and right leg circumference between the two groups.The baseline levels of the two groups were consistent and comparable before intervention.（2）After 7 days of intervention,comparison of the occurrence and incidence of DVT between the two groups:a total of 10 patients in the control group developed DVT,and the incidence of thrombosis was 15.15%（location:left calf in 4 cases,right calf in 3 cases,double calf in 1 case,and left thigh in 2 cases）.Pain and swelling:4 cases had no conscious symptoms,3cases had left leg pain,1 case had right leg pain,1 case had double leg pain,and 2 cases had left thigh pain;In the experimental group,DVT occurred in 2 patients,and the incidence of thrombosis was 3.03%（site:left calf in 2 cases）.Pain and swelling:2 patients had no conscious symptoms.The incidence of DVT in the experimental group was lower than that in the control group,and the difference was statistically significant（X~2=5.867,P=0.015）（3）Comparison of coagulation function:（1）After 7 days of intervention,there was no statistical significance in the comparison of activated partial thrombin time,prothrombin time,thrombin time and platelet count between the two groups.However,d-dimer（0.50?0.30）mg/L and fibrinogen（3.23?0.73）g/L in experimental group were lower than those in control group（0.96?1.23）mg/L and fibrinogen（3.62?1.04）g/L.The difference of D-dimer（t=2.919,P=0.004）and fibrinogen（t=2.540,P=0.012）between 2 groups was statistically significant.（2）Intra-group comparison before and after intervention,control group:There was no significant difference in activated partial thrombin time（t=0.598,P=0.552）,prothrombin time（t=1.724,P=0.089）,thrombin time（t=-1.852,P=0.069）and platelet count（t=-1.091,P=0.279）.While d-dimer（t=-3.551,P=0.001）and fibrinogen（t=-4.560,P<0.001）were higher than before intervention,the difference was statistically significant.The experimental group:Activated partial thrombin time（t=-0.416,P=0.679）,D-dimer（t=0.482,P=0.632）,fibrinogen（t=-1.345,P=0.183）,prothrombin time（t=-0.188,P=0.851）,Thrombin time（t=1.090,P=0.280）and platelet count（t=-0.042,P=0.966）had no statistical significance.（4）Comparison of muscle strength of lower limbs:（1）After 7 days of intervention,the scores of left and right muscle strength of lower limbs in the experimental group were higher than those in the control group,the left muscle strength（t=-3.551,P=0.001）and the right muscle strength（t=-2.405,P=0.018）,the differences were statistically significant.（2）Compared within the group before and after intervention,the muscle strength of lower limbs in both groups was improved.Control group:left side（t=-4.143,P<0.001）,right side（t=-2.132,P=0.037）;Experimental group:left side（t=-6.528,P<0.001）,right side（t=-4.955,P<0.001）,the differences were statistically significant.（5）Comparison of lower leg circumference diameter difference:（1）After 7 days of intervention,the comparison of lower leg circumference diameter difference between the two groups:the control group（0.70?0.48）cm was larger than the experimental group（0.54?0.25）cm,the difference was statistically significant（t=2.369,P=0.019）.However,there was no statistically significant difference between the two groups.（2）Compared within the group before and after intervention,the difference of leg circumference diameter in the control group was as follows:thigh（t=-1.463,P=0.148）,calf（t=-3.115,P=0.003）.After intervention,the difference of leg circumference diameter in the control group increased,and the difference was statistically significant.Leg circumference difference of the experimental group:thigh（t=-1.121,P=0.267）,calf（t=-0.792,P=0.431）,the difference was not statistically significant.（6）Comparison of patients’satisfaction between the two groups:the score of patients’satisfaction with physiotherapy in the experimental group was（4.68?0.50）higher than that in the control group（3.85?1.18）,and the difference was statistically significant（t=-5.281,P<0.001）.（7）Occurrence of adverse reactions and safety adverse events during intervention:there was1 case of adverse reactions in this study,which occurred during the active treadmill period in the experimental group,with an incidence rate of 1.52%.The adverse reactions were mild,and the patient’s condition improved after the nurse treated the patients according to the emergency treatment flow chart.During the active treadmill period,the patient’s heart rate reached 125beats/min and blood pressure increased to 163/95mm Hg.The nurse immediately asked the patient to stop the treadmill,and the patient’s heart rate and blood pressure returned to the normal range after a rest of 10min.The next day,the patient’s vital signs were stable and no adverse reactions occurred after the treadmill mode was adjusted to passive mode.None of the patients had safety adverse events such as pipeline shedding or deterioration of their condition during the intervention.Research Conclusion:（1）Early bed bike combined with pneumatic pump within 72 hours after admission can effectively prevent the formation of lower extremity deep vein thrombosis in patients with ischemic stroke,improve the hypercoagulability of blood,improve the muscle strength of lower extremity in patients with stroke,and help reduce the swelling degree of the leg.（2）Early bed bike combined with pneumatic pump can improve the satisfaction of physical therapy in stroke patients.（3）Early bed bike combined with pneumatic pump within 72 hours of admission is safe and feasible. |
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