术中不同物理干预预防对妇科肿瘤患者术后下肢深静脉血栓发生的影响  

Effects of intraoperative physical prevention on postoperative deep vein thrombosis in gynecological tumor patients

作　　者：翟娟娟 戴靖华[1] 吴春梅[1] 高文汇[1] Zhai Juanjuan;Dai Jinghua;Wu Chunmei;Gao Wenhui(Department of Anesthesiology and Surgery,Shanxi Provincial People's Hospital,Taiyuan 030000,China)

机构地区：[1]山西省人民医院麻醉手术科,太原030000

出　　处：《中华现代护理杂志》2022年第11期1499-1503,共5页Chinese Journal of Modern Nursing

基　　金：山西省重点研发计划项目(201903D321171)。

摘　　要：目的探讨术中不同物理干预对妇科肿瘤患者术后下肢深静脉血栓(DVT)发生的影响。方法采用便利抽样法,选取2020年1—12月在山西省人民医院行手术治疗的79例妇科肿瘤患者为研究对象,按照随机数字表法分将其分为观察组(n=40)和对照组(n=39)。对照组患者术中采用梯度压力弹力袜(GCS)进行干预,观察组患者术中采用GCS联合足底动静脉泵干预。分别于术前、术毕即刻、术后第3天比较两组患者的血凝指标[D-二聚体水平、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、下肢静脉(股总静脉、股深静脉)管径和血液流速及术后第1天、第3天、1个月、3个月的DVT发生率。结果重复测量方差分析显示,两组患者术前、术毕即刻、术后第3天的D-二聚体水平、PT、APTT比较存在交互、组间、时间效应;股总静脉管径、股深静脉管径、静脉血液流速比较存在交互、组间、时间效应,差异均有统计学意义(P<0.05);术后第1天、第3天、1个月、3个月,观察组患者DVT发生率均低于对照组,差异均有统计学意义(P<0.05)。结论术中GCS联合足底动静脉泵可改善妇科肿瘤患者术后凝血功能,加快下肢静脉血液流速,降低患者DVT的发生率。Objective To explore the effect of intraoperative physical prevention on the occurrence of lower extremity deep vein thrombosis(DVT)in patients with gynecological tumors after operation.Methods From January to December 2020,convenience sampling was used to select 79 gynecological tumor patients with operations in Shanxi Provincial People's Hospital as the research object.According to the random number table method,the patients were divided into the observation group(n=40)and the control group(n=39).The patients in the control group received graduated compression stocking(GCS)during the operation,and the patients in the observation group were treated with the GCS combined with the plantar arteriovenous pump.The blood coagulation indexes[D-dimer,prothrombin time(PT),activated partial thromboplastin time(APTT)],lower extremity(common femoral vein,deep femoral vein)venous diameter and blood flow rate before operation,immediately after operation,and on the third day after operation,and the incidence of DVT on the first day,third day,1 month and 3 months after the operation were compared between the two groups.Results Repeated measures analysis of variance showed that there were interaction,between-group and time effects in the comparison of D-dimer,PT,and APTT before operation,immediately after operation,and on the third day after operation between the two groups.There were interactions,between-group,and time effects in the comparison of the diameter of the common femoral vein,the diameter of the deep femoral vein,and the venous blood flow rate.The differences were all statistically significant(P<0.05).On the first day,third day,1 month and 3 months after operation,the incidences of DVT in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Intraoperative GCS combined with plantar arteriovenous pump can improve postoperative coagulation function in patients with gynecological tumors,accelerate venous blood flow rate of lower extremitie

关 键 词：静脉血栓形成 妇科肿瘤 物理预防 梯度压力弹力袜 足底动静脉泵 

分 类 号：R473.73[医药卫生—护理学]