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Bed rest or ambulation in the initial treatment of patients with acute deep vein thrombosis or pulmonary embolism: findings from the RIETE registry.急性深静脉血栓形成或肺栓塞患者初始治疗中的卧床休息或活动：来自RIETE注册研究的结果
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8
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Can Fam Physician. 2005 Feb;51(2):217-23.
10
Management of venous thromboembolism: why not treat it at home?静脉血栓栓塞症的管理：为何不在家中治疗？
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深静脉血栓形成后的行走：一项系统综述。

Ambulation after deep vein thrombosis: a systematic review.

作者信息

Anderson Cathy M, Overend Tom J, Godwin Julie, Sealy Christina, Sunderji Aisha

机构信息

Cathy M. Anderson, BHSc PT, MSc: Clinical Specialist, Physiotherapy, London Health Sciences Centre, London, Ontario.

出版信息

Physiother Can. 2009 Summer;61(3):133-40. doi: 10.3138/physio.61.3.133. Epub 2009 Jul 16.

DOI:10.3138/physio.61.3.133
PMID:20514175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2787576/
Abstract

PURPOSE

To systematically review the effects of early ambulation on development of pulmonary embolism (PE) and progression or development of a new thrombus in patients with acute deep vein thrombosis (DVT).

METHODS

Medline, PubMed, CINAHL, EMBASE, PEDro, and Cochrane Library databases were searched from inception to June 2008. Study quality was appraised using the Jadad and PEDro scales. Meta-analyses were reported as relative risks (RR) and 95% confidence intervals (CI).

RESULTS

Four randomized trials were accepted. For development of a PE, the pooled relative risks for ambulation and compression versus bed rest and compression (RR = 0.63, 95% CI: 0.34-1.19) and for ambulation and compression versus bed rest alone (RR = 1.36, 95% CI: 0.57-3.29) were not significant. For progression of an existing thrombus or development of a new thrombus, the independent relative risks for ambulation and compression versus bed rest and compression (RR = 0.39, 95% CI: 0.13-1.14) and for ambulation and compression versus bed rest alone (RR = 0.56, 95% CI: 0.20-1.57) were also not significant.

CONCLUSIONS

Given the clinical benefits of mobility, and because there was no significant difference between ambulation and bed rest for risk of developing a PE or development and progression of a new DVT in any of the studies, clinicians should be confident in prescribing ambulation in this population.

摘要

目的

系统评价早期活动对急性深静脉血栓形成（DVT）患者发生肺栓塞（PE）以及现有血栓进展或新血栓形成的影响。

方法

检索Medline、PubMed、CINAHL、EMBASE、PEDro和Cochrane图书馆数据库，检索时间从建库至2008年6月。采用Jadad和PEDro量表评估研究质量。荟萃分析结果以相对风险（RR）和95%置信区间（CI）表示。

结果

纳入4项随机试验。对于PE的发生，活动加加压与卧床加加压相比（RR = 0.63，95%CI：0.34 - 1.19）以及活动加加压与单纯卧床相比（RR = 1.36，95%CI：0.57 - 3.29），汇总相对风险均无统计学意义。对于现有血栓进展或新血栓形成，活动加加压与卧床加加压相比（RR = 0.39，95%CI：0.13 - 1.14）以及活动加加压与单纯卧床相比（RR = 0.56，95%CI：0.20 - 1.57），独立相对风险也无统计学意义。

结论

鉴于活动具有临床益处，且在任何研究中活动与卧床在发生PE风险或新DVT形成及进展方面均无显著差异，临床医生在为该人群开具活动医嘱时应充满信心。