术中间歇性气囊加压法在妇科腹腔镜患者中的应用  

Effect of intraoperative IPC on patients with gynaecological laparoscopic surgery

作　　者：苏润霞[1] 梁月娥[1] 吴永红[1] 彭嘉怡[1] 

机构地区：[1]广东省妇幼保健院手术室,广东广州510010

出　　处：《现代临床护理》2013年第7期46-49,共4页Modern Clinical Nursing

基　　金：广东省医学科研基金立项课题;项目编号为A2012101

摘　　要：目的探讨术中间歇性气囊加压法(intermittent pneumatic compression method,IPC)在妇科腹腔镜患者中的应用效果。方法将200例不孕症行腹腔探查患者分为观察组和对照组,每组各100例。两组均在全身麻醉和膀胱截石位下行腹腔镜手术,术中对照组不采用任何干预措施,观察组采用IPC。比较两组患者术前、术后第1d和第3d凝血功能指标;术前、手术后30min、术后第1d股静脉血流速度;术后3个月深静脉血栓(deep vein thrombosis,DVT)发生率的差异。结果术后3个月对照组发生DVT12例,观察组2例,两组比较,χ2=6.22,P<0.05,差异具有统计学意义。观察组患者术后第1d凝血酶原时间(prothrombintime,PT)和凝血活酶时间(activated par-tialthrom boplastin time,APTT)高于对照组,术后第1d和第3d纤维蛋白原(human fibrinogen,FIB)低于对照组(均P<0.05)。术后30min和术后24h观察组患者股静脉血流速度大于对照组,两组比较,差异具有统计学意义(均P<0.05)。观察组各时间点股静脉血流速度比较,F=1.94,P>0.05,差异无统计学意义。结论 IPC应用于腹腔镜手术是安全有效的,能改善下肢血液循环和预防下肢DVT的发生,值得临床推广应用。Objective To study the effect of intraoperative intermittent pneumatic compression（IPC）on patients undergoing gynaecological laparoscopic surgery.Methods Two hundred infertile patients to undergo exploratory laparotomy were randomized equally into the observation group and the control group.The patients in both groups were managed with laparoscopic operation at lithotomy position under general anaesthesia.During the operation,the control group was treated with nil intervention,while the observation group with IPC.The two groups were compared in terms of blood coagulation indexes before operation,days 1 and 3 after operation,blood flow rate of femoral vein before operation,30 mins and day 1 after the operation,and deep vein thrombosis（DVT） three months after operation.Results Three months after operation,12 cases of DVT occurred in the control group,and only 2 cases in the observation group.The difference was significant between the groups（χ 2 =6.22, P 0.05）.The prothrombintime time and activated par-tialthrom boplastin time in the observation group were both longer than those of the control group,but the human fibrinogen was less（all P 0.05）.The blood flow rate of femoral vein in the observation group was higher than that of the control group 30 mins and day 1 after operation（ P 0.05）,though the rates of femoral vein in the observation group showed insignificant differences between all the time points（ F =1.94, P 0.05）.Conclusion IPC used during laparoscopic surgery may be safe and effective as a result of improving blood circulation of lower limbs and preventing venothrombosis in lower limbs.

关 键 词：妇科 腹腔镜手术 间断性气囊加压法 深静脉血栓 

分 类 号：R473.71[医药卫生—护理学]