摘要
目的探讨术中应用不同模式间歇充气加压装置(IPC)预防直肠癌腹腔镜手术后静脉血栓的效果。方法抽取郑州大学第五附属医院2020年1月至2022年8月收治的直肠癌腹腔镜手术患者138例,按双色球法分为三组,每组46例。对照组采用常规护理预防静脉血栓,观察A组采用IPC双足模式预防静脉血栓,观察B组采用IPC双小腿模式预防静脉血栓。比较三组预防静脉血栓的效果。结果术后1 d,观察A组、观察B组活化部分凝血活酶时间、凝血酶原时间高于对照组,纤维蛋白原、D-二聚体水平低于对照组(P<0.05)。术后1 d,观察A组、观察B组血细胞比容、低切变率全血黏度、高切变率全血黏度低于对照组(P<0.05)。术后1 d,观察A组、观察B组股静脉直径、血流峰速度、血流平均速度、血流量均高于对照组(P均<0.05)。术后3、7 d,观察A组静脉血栓发生率分别为0(0/46),2.17%(1/46),观察B组分别为0(0/46)、4.34%(2/46),均低于对照组的15.22%(7/46)、19.56%(1/46),P<0.05。结论直肠癌腹腔镜手术患者采取IPC双小腿模式或双足模式预防静脉血栓均能取得较好的效果,与常规预防措施比较,两种方法均能更好地改善患者术后的凝血指标、血液流变学指标及股静脉指标,而且能明显降低静脉血栓发生率,临床可根据患者、医院相关情况灵活选择IPC模式。
Objective To investigate the effect of intermittent pneumatic compression(IPC)at different modes during laparoscopic surgery in preventing postoperative venous thrombosis in patients with rectal cancer.Methods A total of 138 patients with rectal cancer treated by laparoscopic surgery in the Fifth Affiliated Hospital of Zhengzhou University from January 2020 to August 2022 were selected for the research,and they were divided into three groups by the two-sphere method,with 46 cases in each group.The control group was treated by routine nursing for prevention of venous thrombosis,the observation group A was treated by IPC double-foot mode,and the observation group B was treated by IPC-double calf mode to prevent venous thrombosis.The effect on preventing venous thrombosis in the three groups were compared.Results One day after operation,the activated partial thromboplastin time,prothrombin time in observation group A and observation group B were higher than those in control group,while levels of fibrinogen and D-dimer were lower than those in control group(P<0.05).One day after operation,the hematocrit,blood viscosity at low shear rate,blood viscosity at high shear rate in observation group A and observation group B were lower than those in control group(P<0.05).One day after operation,the femoral vein diameter,peak blood flow velocity,average blood flow velocity,and blood flow in observation group A and observation group B were higher than those in control group(all P<0.05).Three and seven days after operation,the incidence of venous thrombosis in observation group A were 0(0/46)and 2.17%(1/46),respectively,which were 0(0/46)and 4.34%(2/46)in observation group B,moreover,the incidences of the two groups were lower than those in the control group(15.22%,7/46;19.56%,1/46),P<0.05.Conclusions IPC double-calf model or double-foot model can achieve good results in the prevention of venous thrombosis in patients with rectal cancer treated by laparoscopic surgery.Compared with conventional preventive measures,both modes can better improve postoperative coagulation indexes,hemorheological indexes and femoral vein indicators.They can significantly reduce the incidence of venous thrombosis.The IPC mode can be flexibly selected according to the relevant conditions of patients and hospitals.
作者
杨楠
傅聿铭
韩晓霞
王春丽
Yang Nan;Fu Yuming;Han Xiaoxia;Wang Chunli(Department of Anesthesia,Operation Section,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Gastrointestinal and Thyroid Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Nursing,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Zhengzhou Orthopedic Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2023年第5期46-49,共4页
Chinese Journal of Practical Medicine
关键词
直肠癌
腹腔镜手术
静脉血栓
间歇充气加压装置
双足模式
双小腿模式
凝血指标
血液流变学
Rectal neoplasms
Laparoscopic surgery
Venous thrombosis
Intermittent pneumatic compression device
Bipedal mode
Bi-calf mode
Coagulation index
Hemorheology
作者简介
通信作者:王春丽,Email:yn9834@sina.com。
